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Maine 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 $91 · 10th–90th $40–$1820%20%10th90th$91Professionalmedian $50 · 10th–90th $28–$1000%10%20%10th90th$50$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$22.39 / $77.62 / $154.88
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$50.12 / $109.65 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $46.77 / $95.50
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$30.90 / $54.95 / $112.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $51.29 / $89.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $50.12 / $102.33
Community Health Options
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $87.10 / $112.20
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $72.44 / $141.25
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.39 / $39.81 / $4,365.16
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $42.66 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $60.26 / $112.20
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$60.26 / $79.43 / $112.20