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Ohio 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 $78 · 10th–90th $47$1660%20%10th90th$78Professionalmedian $87 · 10th–90th $50$1910%10%20%10th90th$87$1.0$5.0$20.0$100.0$500.0$2.0K

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
$46.77 / $77.62 / $131.83
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$46.77 / $70.79 / $229.09
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$48.98 / $48.98 / $48.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $85.11 / $190.55
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 / $269.15 / $524.81
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $79.43 / $117.49
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$61.66 / $89.13 / $120.23
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
$47.86 / $67.61 / $112.20
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $89.13 / $128.82
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $70.79 / $102.33
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $93.33 / $181.97
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $120.23 / $165.96
Cigna
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Cigna
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
Cigna
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$10.23 / $10.23 / $10.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $81.28 / $144.54
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $102.33 / $204.17
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$10.23 / $10.23 / $10.23
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $91.20 / $128.82
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $63.10
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $89.13 / $147.91
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $87.10 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $52.48 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $72.44 / $128.82
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$75.86 / $89.13 / $120.23