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Massachusetts 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 $21$1510%5%10%10th90th$51Professionalmedian $58 · 10th–90th $30$1350%5%10th90th$58$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
$24.55 / $57.54 / $144.54
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$93.33 / $446.68 / $588.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $53.70 / $128.82
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$32.36 / $60.26 / $147.91
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $117.49 / $223.87
AllWays Health Partners
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
AllWays Health Partners
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$22.39 / $22.39 / $22.39
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $57.54 / $181.97
AllWays Health Partners
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$19.50 / $33.88 / $70.79
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $63.10 / $91.20
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $69.18 / $123.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $194.98 / $263.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $52.48 / $104.71
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $27.54 / $51.29
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $52.48 / $95.50
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $72.44 / $144.54
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $64.57 / $83.18
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $81.28 / $165.96
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $117.49 / $223.87
Mass General Brigham
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Mass General Brigham
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$22.39 / $22.39 / $22.39
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $57.54 / $181.97
Mass General Brigham
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$19.50 / $33.88 / $70.79
Tufts
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.62 / $26.92 / $83.18
Tufts
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $43.65 / $102.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $48.98 / $66.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $58.88 / $138.04
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$67.61 / $85.11 / $100.00