go back

Delaware rates for HCPCS 99205

Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.

Facilitymedian $174 · 10th–90th $145–$1,0000%20%10th90th$174Professionalmedian $219 · 10th–90th $141–$4790%10%10th90th$219$20.0$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $173.78 / $1,000.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $204.17 / $446.68
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$177.83 / $371.54 / $616.60
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $131.83 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $213.80 / $371.54
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $281.84 / $398.11
Highmark BCBS
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$194.98 / $234.42 / $501.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $186.21 / $338.84
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $89.13 / $426.58