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Montana 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 $112 · 10th–90th $56–$1580%10%20%10th90th$112Professionalmedian $89 · 10th–90th $50–$2140%10%10th90th$89$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
$52.48 / $138.04 / $316.23
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$125.89 / $125.89 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $89.13 / $213.80
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$48.98 / $91.20 / $208.93
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$257.04 / $269.15 / $269.15
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $123.03 / $144.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $102.33 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $85.11 / $158.49
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $117.49 / $158.49
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $117.49 / $158.49
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $81.28 / $147.91
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $125.89 / $239.88
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
$63.10 / $91.20 / $134.90
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $114.82 / $144.54