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Maine 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 $98 · 10th–90th $58–$2450%10%20%10th90th$98Professionalmedian $83 · 10th–90th $48–$1820%10%20%10th90th$83$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$57.54 / $91.20 / $229.09
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$72.44 / $123.03 / $281.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $79.43 / $173.78
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$52.48 / $85.11 / $204.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $95.50 / $147.91
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $83.18 / $165.96
Community Health Options
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $138.04 / $181.97
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $125.89 / $229.09
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $66.07 / $120.23
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $70.79 / $131.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $100.00 / $177.83
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $95.50 / $138.04