go back

Michigan 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 $191 · 10th–90th $48–$2510%10%20%10th90th$191Professionalmedian $234 · 10th–90th $145–$5890%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
$47.86 / $190.55 / $251.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $223.87 / $575.44
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$173.78 / $316.23 / $707.95
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
$158.49 / $223.87 / $371.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $213.80 / $257.04
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $245.47 / $309.03
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $229.09 / $309.03
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $275.42 / $489.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $147.91
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $208.93 / $446.68
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $190.55 / $245.47
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $208.93 / $446.68
Health Alliance Plan
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$173.78 / $309.03 / $676.08
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $147.91
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $199.53 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $165.96 / $275.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $204.17 / $389.05
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $295.12 / $478.63