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Georgia 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 $257 · 10th–90th $55$4570%10%20%10th90th$257Professionalmedian $85 · 10th–90th $52$1740%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
$53.70 / $100.00 / $457.09
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$257.04 / $354.81 / $575.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $83.18 / $173.78
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$52.48 / $85.11 / $181.97
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$257.04 / $263.03 / $269.15
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $89.13 / $141.25
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $95.50 / $151.36
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $74.13 / $131.83
Anthem BCBS
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$48.98 / $48.98 / $48.98
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $89.13 / $125.89
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $107.15 / $138.04
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $141.25 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $77.62 / $141.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $97.72 / $169.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
22
Typical Low / Median / Typical High
$169.82 / $213.80 / $302.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
62
Typical Low / Median / Typical High
$52.48 / $67.61 / $93.33
Kaiser Permanente
Facility/Professional
Professional
Modifier
80
Typical Low / Median / Typical High
$4.47 / $5.75 / $7.94
Kaiser Permanente
Facility/Professional
Professional
Modifier
AS
Typical Low / Median / Typical High
$2.24 / $2.88 / $3.98
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $151.36 / $489.78
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $107.15 / $177.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $60.26 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $74.13 / $125.89
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$75.86 / $89.13 / $138.04