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Arizona 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 $100 · 10th–90th $47–$8320%5%10th90th$100Professionalmedian $87 · 10th–90th $50–$2240%10%10th90th$87$5.0$20.0$100.0$500.0

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
$46.77 / $100.00 / $851.14
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$58.88 / $630.96 / $912.01
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $87.10 / $213.80
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$51.29 / $91.20 / $234.42
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$64.57 / $257.04 / $269.15
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $79.43 / $114.82
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$64.57 / $87.10 / $114.82
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.20 / $18.62 / $79.43
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $67.61 / $87.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $114.82 / $234.42
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
$50.12 / $75.86 / $147.91
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $74.13 / $123.03
Medica
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Medica
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$29.51 / $29.51 / $29.51
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $93.33 / $562.34
Medica
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$57.54 / $79.43 / $165.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $46.77 / $56.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $70.79 / $120.23
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$40.74 / $89.13 / $120.23