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Missouri 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 $71 · 10th–90th $30$1820%5%10th90th$71Professionalmedian $54 · 10th–90th $29$1170%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 / $63.10 / $154.88
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$89.13 / $162.18 / $338.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $52.48 / $114.82
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$32.36 / $57.54 / $125.89
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $48.98 / $72.44
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$36.31 / $52.48 / $61.66
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $41.69 / $61.66
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $50.12 / $70.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $147.91 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $45.71 / $83.18
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $45.71 / $89.13
Medica
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$57.54 / $177.83 / $257.04
Medica
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Medica
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$15.85 / $15.85 / $15.85
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $57.54 / $354.81
Medica
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$42.66 / $64.57 / $128.82
Qualchoice
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $61.66 / $74.13
Qualchoice
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$53.70 / $67.61 / $72.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $48.98 / $74.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $42.66 / $83.18
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$28.84 / $79.43 / $89.13