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Washington 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 $245 · 10th–90th $145–$4900%10%10th90th$245Professionalmedian $257 · 10th–90th $145–$6920%5%10th90th$257$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
$138.04 / $251.19 / $549.54
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$660.69 / $660.69 / $1,148.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $239.88 / $676.08
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$165.96 / $316.23 / $758.58
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $275.42 / $446.68
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$186.21 / $269.15 / $446.68
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $338.84 / $512.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $147.91 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $275.42 / $549.54
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $234.42 / $446.68
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $229.09 / $436.52
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $109.65 / $239.88
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $389.05 / $436.52
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $309.03 / $549.54
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $331.13 / $501.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $125.89 / $275.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $263.03 / $457.09
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $162.18 / $457.09
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $239.88 / $338.84