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Vermont 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 $245 · 10th–90th $32–$2950%20%40%10th90th$245Professionalmedian $51 · 10th–90th $28–$1020%5%10th90th$51$10.0$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $53.70 / $245.47
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $47.86 / $100.00
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$31.62 / $57.54 / $114.82
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $74.13 / $74.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $47.86 / $75.86
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $60.26 / $100.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.89 / $32.36 / $69.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $57.54 / $117.49