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Ohio 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 $49 · 10th–90th $32–$1150%20%10th90th$49Professionalmedian $54 · 10th–90th $28–$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
$28.18 / $48.98 / $107.15
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$46.77 / $95.50 / $120.23
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
$31.62 / $58.88 / $125.89
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
$35.48 / $53.70 / $70.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $39.81 / $67.61
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $54.95 / $85.11
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $38.02 / $54.95
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $57.54 / $112.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $109.65 / $165.96
Cigna
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Cigna
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$33.88 / $33.88 / $33.88
Cigna
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$5.37 / $5.37 / $5.37
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $47.86 / $87.10
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $144.54 / $263.03
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$33.88 / $33.88 / $33.88
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$5.37 / $5.37 / $5.37
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $51.29 / $77.62
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $33.11 / $63.10
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $52.48 / $100.00
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $48.98 / $77.62
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $38.02 / $69.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $41.69 / $85.11
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$54.95 / $79.43 / $89.13