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Nationwide rates for HCPCS 99212

Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 10 minutes must be met or exceeded.

Facilitymedian $62 · 10th–90th $29$2510%20%10th90th$62Professionalmedian $54 · 10th–90th $29$1170%20%10th90th$54$0.0$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$28.84 / $64.57 / $257.04
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$64.57 / $147.91 / $426.58
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $51.29 / $114.82
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$32.36 / $57.54 / $125.89
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $35.48 / $46.77
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $42.66 / $77.62
BCBS
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$34.67 / $34.67 / $34.67
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $128.82 / $199.53
Cigna
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Cigna
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$33.88 / $33.88 / $33.88
Cigna
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$5.37 / $5.37 / $5.37
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $50.12 / $100.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.38 / $42.66 / $69.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $48.98 / $107.15
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$52.48 / $79.43 / $100.00