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Maryland 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 $158 · 10th–90th $126–$3890%20%10th90th$158Professionalmedian $234 · 10th–90th $141–$5620%5%10%10th90th$234$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
$131.83 / $363.08 / $645.65
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$125.89 / $131.83 / $141.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $218.78 / $524.81
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$169.82 / $331.13 / $691.83
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $154.88 / $269.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $144.54 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $218.78 / $363.08
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $251.19 / $354.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $162.18 / $199.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $204.17 / $346.74
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $89.13 / $457.09
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $229.09 / $346.74