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Michigan 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 $58 · 10th–90th $32–$1580%5%10%10th90th$58Professionalmedian $55 · 10th–90th $29–$1170%5%10%10th90th$55$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
$31.62 / $57.54 / $131.83
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$67.61 / $102.33 / $478.63
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $52.48 / $117.49
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$33.11 / $58.88 / $123.03
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $51.29 / $72.44
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$38.90 / $54.95 / $70.79
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $57.54 / $60.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $57.54 / $87.10
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $44.67 / $60.26
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $69.18 / $123.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $147.91
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $44.67 / $102.33
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $51.29 / $120.23
Health Alliance Plan
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$67.61 / $102.33 / $389.05
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $47.86 / $102.33
Health Alliance Plan
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$33.11 / $58.88 / $120.23
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $147.91
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $42.66 / $70.79
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $35.48 / $69.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $44.67 / $95.50
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$47.86 / $89.13 / $112.20