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Missouri 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 $54$2690%10%10th90th$95Professionalmedian $85 · 10th–90th $52$1950%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 / $95.50 / $239.88
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$63.10 / $213.80 / $776.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $85.11 / $190.55
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$52.48 / $87.10 / $199.53
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
$53.70 / $81.28 / $109.65
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $85.11 / $109.65
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$83.18 / $83.18 / $83.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $70.79 / $104.71
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $85.11 / $114.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $147.91 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $79.43 / $138.04
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $77.62 / $147.91
Medica
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$69.18 / $234.42 / $407.38
Medica
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Medica
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$29.51 / $29.51 / $29.51
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $102.33 / $562.34
Medica
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$74.13 / $97.72 / $138.04
Qualchoice
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $100.00 / $131.83
Qualchoice
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$72.44 / $93.33 / $117.49
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $74.13 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $72.44 / $123.03
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $89.13 / $138.04