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Texas 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 $47 · 10th–90th $26$1860%10%10th90th$47Professionalmedian $48 · 10th–90th $26$1000%5%10%10th90th$48$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
$28.84 / $74.13 / $316.23
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$50.12 / $162.18 / $323.59
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $47.86 / $100.00
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$29.51 / $56.23 / $117.49
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $51.29 / $70.79
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$36.31 / $54.95 / $66.07
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $27.54 / $46.77
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $33.11 / $48.98
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $56.23 / $100.00
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $42.66 / $57.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $165.96 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $46.77 / $81.28
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $223.87 / $223.87
Lucent Health
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Lucent Health
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$22.39 / $22.39 / $22.39
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $66.07 / $354.81
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $46.77 / $87.10
Moda Health
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$50.12 / $165.96 / $323.59
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $43.65 / $77.62
Moda Health
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$28.84 / $54.95 / $117.49
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $25.70 / $33.11
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $79.43 / $186.21
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $72.44 / $213.80
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $47.86 / $87.10
Providence
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
Providence
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$31.62 / $31.62 / $31.62
Providence
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$5.01 / $5.01 / $5.01
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $47.86 / $89.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $41.69 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $39.81 / $69.18
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$60.26 / $89.13 / $89.13
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $58.88 / $64.57