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Illinois 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 $98 · 10th–90th $32–$2450%5%10%10th90th$98Professionalmedian $54 · 10th–90th $30–$1150%5%10%10th90th$54$1.0$5.0$20.0$100.0$500.0

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 / $85.11 / $239.88
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$61.66 / $107.15 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $52.48 / $114.82
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$31.62 / $57.54 / $120.23
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $53.70 / $75.86
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$35.48 / $54.95 / $74.13
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27.54 / $123.03 / $138.04
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $48.98 / $64.57
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $125.89 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $51.29 / $89.13
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $69.18 / $114.82
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $63.10 / $74.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $91.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $54.95 / $69.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $58.88 / $107.15
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$60.26 / $79.43 / $100.00