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Nevada 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 $407 · 10th–90th $162–$4170%50%10th90th$407Professionalmedian $240 · 10th–90th $145–$7080%10%20%10th90th$240$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $407.38 / $407.38
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $229.09 / $691.83
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$165.96 / $275.42 / $776.25
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $229.09 / $346.74
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$186.21 / $229.09 / $302.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $213.80 / $380.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $134.90 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $213.80 / $346.74
Hometown Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $204.17 / $316.23
Hometown Health
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$870.96 / $870.96 / $870.96
Hometown Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $239.88 / $354.81
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $234.42 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $169.82 / $281.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $204.17 / $354.81
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $251.19 / $426.58