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Washington 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 $56 · 10th–90th $28–$1320%5%10%10th90th$56Professionalmedian $58 · 10th–90th $30–$1450%5%10%10th90th$58$2.0$10.0$50.0$200.0$1.0K

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
$39.81 / $64.57 / $131.83
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$52.48 / $213.80 / $457.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $54.95 / $141.25
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$33.11 / $63.10 / $154.88
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $61.66 / $112.20
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$47.86 / $64.57 / $114.82
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $75.86 / $120.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $74.13 / $147.91
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
$26.92 / $56.23 / $123.03
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.44 / $42.66 / $100.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $42.66 / $95.50
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $33.11 / $61.66
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $85.11 / $112.20
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $75.86
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $74.13 / $138.04
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $75.86 / $117.49
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.22 / $25.70 / $109.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $56.23 / $100.00
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$36.31 / $70.79 / $89.13
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $61.66 / $87.10