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Indiana 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 $40–$3550%10%20%10th90th$89Professionalmedian $85 · 10th–90th $51–$1660%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
$38.02 / $85.11 / $338.84
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$87.10 / $208.93 / $478.63
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $83.18 / $165.96
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$52.48 / $85.11 / $173.78
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$38.02 / $64.57 / $123.03
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $83.18 / $120.23
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$63.10 / $89.13 / $125.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $77.62 / $120.23
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $77.62 / $95.50
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $100.00 / $131.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $102.33 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $75.86 / $128.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $61.66 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $69.18 / $123.03
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $91.20 / $144.54