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Connecticut 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 $219 · 10th–90th $63–$3630%10%20%10th90th$219Professionalmedian $85 · 10th–90th $49–$2040%10%20%10th90th$85$1.0$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
$58.88 / $218.78 / $380.19
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$93.33 / $223.87 / $263.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $85.11 / $194.98
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$52.48 / $89.13 / $218.78
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$38.02 / $64.57 / $131.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $75.86 / $123.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $181.97 / $251.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $85.11 / $154.88
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $112.20 / $151.36
ConnectiCare
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$114.82 / $158.49 / $190.55
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $181.97 / $181.97
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $123.03 / $190.55
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $89.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $93.33 / $173.78
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $104.71 / $177.83