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Virginia 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 $46 · 10th–90th $26–$980%10%20%10th90th$46Professionalmedian $52 · 10th–90th $28–$1120%10%20%10th90th$52$1.0$5.0$20.0$100.0$500.0$2.0K

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
$24.55 / $43.65 / $120.23
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$81.28 / $91.20 / $263.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $50.12 / $112.20
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$32.36 / $56.23 / $120.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $58.88 / $100.00
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $28.18 / $48.98
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $141.25 / $204.17
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
$28.18 / $47.86 / $85.11
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $67.61 / $100.00
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $45.71 / $63.10
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27.54 / $46.77 / $81.28
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $87.10
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $33.88 / $58.88
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $54.95 / $91.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $31.62 / $48.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $40.74 / $77.62
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$52.48 / $79.43 / $100.00