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Wisconsin 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 $91 · 10th–90th $32$3550%5%10%10th90th$91Professionalmedian $59 · 10th–90th $30$1480%10%10th90th$59$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
$38.90 / $104.71 / $323.59
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$89.13 / $251.19 / $549.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $53.70 / $147.91
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$33.88 / $63.10 / $151.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $64.57 / $114.82
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $42.66 / $61.66
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $66.07 / $123.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $177.83 / $281.84
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
$35.48 / $81.28 / $162.18
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $42.66 / $85.11
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $89.13 / $144.54
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $44.67 / $97.72
Medica
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
Medica
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$93.33 / $100.00 / $100.00
Medica
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$15.14 / $15.85 / $15.85
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $97.72 / $354.81
Medica
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $114.82 / $147.91
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $74.13
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $70.79 / $112.20
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $87.10 / $144.54
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $223.87
Quartz
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Quartz
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$40.74 / $40.74 / $141.25
Quartz
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$6.61 / $6.61 / $22.39
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $72.44 / $354.81
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $66.07
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $72.44 / $117.49
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $45.71 / $61.66
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $95.50 / $138.04
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $79.43 / $91.20