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Florida 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 $49–$4790%10%20%10th90th$174Professionalmedian $229 · 10th–90th $145–$5500%5%10%10th90th$229$10.0$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
$51.29 / $169.82 / $478.63
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$18.62 / $354.81 / $537.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $218.78 / $512.86
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$173.78 / $316.23 / $676.08
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $223.87 / $331.13
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$177.83 / $229.09 / $323.59
AvMed
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $165.96 / $181.97
AvMed
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $190.55 / $245.47
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $186.21 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $229.09 / $398.11
Florida Blue
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $269.15 / $416.87
Florida Blue
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $173.78 / $275.42
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $186.21 / $354.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $162.18 / $194.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $190.55 / $363.08
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $208.93 / $426.58
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $169.82 / $234.42