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Idaho 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 $95 · 10th–90th $41–$1910%5%10th90th$95Professionalmedian $91 · 10th–90th $52–$2190%5%10%10th90th$91$5.0$10.0$20.0$50.0$100.0$200.0$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
$40.74 / $89.13 / $181.97
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$40.74 / $181.97 / $257.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $89.13 / $213.80
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$53.70 / $93.33 / $223.87
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $51.29
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $134.90 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $117.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $95.50 / $154.88
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $85.11 / $144.54
Moda Health
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$40.74 / $154.88 / $245.47
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $91.20 / $190.55
Moda Health
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$53.70 / $93.33 / $229.09
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $177.83
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $112.20 / $158.49
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $89.13 / $169.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $85.11 / $138.04
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $89.13 / $138.04