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Kentucky 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 $36 · 10th–90th $23–$1000%10%10th90th$36Professionalmedian $51 · 10th–90th $28–$1020%10%10th90th$51$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
$22.91 / $35.48 / $64.57
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$79.43 / $165.96 / $338.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $50.12 / $100.00
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$31.62 / $56.23 / $114.82
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $51.29 / $72.44
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$41.69 / $54.95 / $72.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $36.31 / $52.48
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $38.02 / $53.70
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $58.88 / $81.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $54.95 / $54.95
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
$26.92 / $46.77 / $263.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $32.36 / $72.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $69.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $38.02 / $70.79
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $89.13 / $89.13