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Idaho 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 $251 · 10th–90th $129–$3550%10%10th90th$251Professionalmedian $257 · 10th–90th $151–$6760%5%10%10th90th$257$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
$26.92 / $263.03 / $354.81
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $245.47 / $616.60
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$169.82 / $316.23 / $707.95
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $371.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $363.08 / $446.68
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $257.04 / $389.05
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $234.42 / $380.19
Moda Health
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $263.03 / $524.81
Moda Health
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$169.82 / $331.13 / $707.95
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $436.52
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $281.84 / $416.87
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $251.19 / $416.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $275.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $245.47 / $363.08
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $91.20 / $478.63