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California 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 $89 · 10th–90th $55–$2820%20%10th90th$89Professionalmedian $93 · 10th–90th $55–$2340%20%10th90th$93$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
$64.57 / $141.25 / $302.00
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$154.88 / $239.88 / $478.63
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $93.33 / $229.09
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$53.70 / $95.50 / $245.47
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$257.04 / $269.15 / $269.15
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $89.13 / $134.90
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $91.20 / $134.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $69.18 / $75.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $79.43 / $138.04
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $89.13
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $102.33 / $199.53
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $151.36 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $85.11 / $162.18
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $64.57 / $134.90
HealthNet
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $144.54 / $275.42
HealthNet
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $194.98 / $251.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $95.50 / $173.78
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $630.96
Lucent Health
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Lucent Health
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$41.69 / $41.69 / $41.69
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $120.23 / $562.34
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $33.11 / $724.44
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $91.20 / $147.91
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $81.28 / $138.04
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $87.10 / $186.21
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $75.86 / $194.98
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $44.67 / $107.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $91.20 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $72.44 / $141.25
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$48.98 / $85.11 / $123.03