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Utah 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 $295 · 10th–90th $245–$4070%20%10th90th$295Professionalmedian $251 · 10th–90th $141–$6920%5%10th90th$251$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
$245.47 / $295.12 / $407.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $239.88 / $691.83
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$165.96 / $281.84 / $724.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $190.55 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $223.87 / $407.38
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $281.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $251.19 / $338.84
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $263.03 / $562.34
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $263.03 / $467.74
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
$144.54 / $213.80 / $346.74
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11