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California 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 $51 · 10th–90th $29–$2240%10%20%10th90th$51Professionalmedian $59 · 10th–90th $33–$1450%10%20%10th90th$59$1.0$5.0$20.0$100.0$500.0$2.0K

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
$38.90 / $138.04 / $354.81
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$91.20 / $194.98 / $363.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $57.54 / $147.91
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$33.88 / $60.26 / $147.91
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $54.95 / $85.11
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$42.66 / $56.23 / $79.43
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $35.48 / $39.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $50.12 / $81.28
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $89.13
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $63.10 / $120.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $151.36 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $50.12 / $97.72
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $34.67 / $89.13
HealthNet
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $60.26 / $79.43
HealthNet
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$173.78 / $173.78 / $173.78
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $58.88 / $109.65
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $223.87
Lucent Health
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Lucent Health
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$22.39 / $22.39 / $22.39
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $112.20 / $354.81
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $33.11 / $724.44
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $66.07 / $104.71
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27.54 / $47.86 / $85.11
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $53.70 / $112.20
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $66.07 / $120.23
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $28.18 / $67.61
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $48.98 / $69.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $42.66 / $89.13
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$52.48 / $79.43 / $89.13