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New Jersey 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 $19–$2950%5%10%10th90th$91Professionalmedian $51 · 10th–90th $28–$1020%5%10%10th90th$51$10.0$20.0$50.0$100.0$200.0$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
$19.50 / $66.07 / $302.00
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$141.25 / $269.15 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $48.98 / $102.33
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$30.90 / $56.23 / $109.65
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
$37.15 / $54.95 / $61.66
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $436.52
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $45.71 / $95.50
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $169.82 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $48.98 / $89.13
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $38.90 / $81.28
Emblem Health
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$69.18 / $85.11 / $128.82
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $54.95 / $87.10
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $60.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $43.65 / $87.10
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$52.48 / $79.43 / $89.13