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Maryland 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 $110 · 10th–90th $50–$2570%10%20%10th90th$110Professionalmedian $85 · 10th–90th $48–$1910%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
$46.77 / $89.13 / $263.03
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$93.33 / $128.82 / $134.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $83.18 / $186.21
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$52.48 / $89.13 / $204.17
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$257.04 / $263.03 / $269.15
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $51.29 / $91.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $144.54 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $77.62 / $131.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $102.33 / $144.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $46.77 / $70.79
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $70.79 / $125.89
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$87.10 / $95.50 / $144.54
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $95.50 / $141.25