search again

Nationwide rates for HCPCS 99213

Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.

Facilitymedian $95 · 10th–90th $50$3310%20%10th90th$95Professionalmedian $87 · 10th–90th $51$1950%20%40%10th90th$87$0.0$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$48.98 / $93.33 / $316.23
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$67.61 / $213.80 / $549.54
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$48.98 / $48.98 / $48.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $85.11 / $190.55
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$52.48 / $89.13 / $204.17
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$64.57 / $263.03 / $269.15
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $69.18 / $75.86
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $72.44 / $128.82
BCBS
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$48.98 / $48.98 / $48.98
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $141.25 / $239.88
Cigna
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Cigna
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
Cigna
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$10.23 / $10.23 / $10.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $83.18 / $169.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $61.66 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $77.62 / $169.82
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $89.13 / $138.04