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Washington, DC 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 $132 · 10th–90th $95–$2190%20%10th90th$132Professionalmedian $85 · 10th–90th $49–$1860%10%10th90th$85$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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
$95.50 / $131.83 / $218.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $83.18 / $181.97
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$52.48 / $87.10 / $194.98
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $53.70 / $85.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $75.86 / $158.49
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $107.15 / $147.91
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $58.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $75.86 / $144.54
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $89.13 / $120.23