go back

Indiana 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 $141 · 10th–90th $98–$2880%10%20%10th90th$141Professionalmedian $229 · 10th–90th $141–$4900%10%10th90th$229$1.0$5.0$20.0$100.0$500.0

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
$97.72 / $128.82 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $218.78 / $467.74
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$169.82 / $309.03 / $575.44
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $223.87 / $309.03
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$169.82 / $229.09 / $309.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $208.93 / $316.23
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $213.80 / $263.03
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $245.47 / $323.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $120.23 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $213.80 / $354.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $162.18 / $275.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $190.55 / $323.59
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $95.50 / $295.12