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West Virginia 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 $182 · 10th–90th $117–$2340%10%20%10th90th$182Professionalmedian $219 · 10th–90th $138–$4070%5%10%10th90th$219$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
$30.20 / $173.78 / $213.80
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $204.17 / $398.11
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$173.78 / $309.03 / $467.74
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $204.17 / $288.40
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $223.87 / $489.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $281.84 / $281.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $223.87 / $758.58
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $229.09 / $309.03
Highmark BCBS
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$218.78 / $239.88 / $363.08
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
$123.03 / $194.98 / $331.13
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $89.13 / $269.15