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Rhode Island 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 $93 · 10th–90th $51–$3240%20%10th90th$93Professionalmedian $85 · 10th–90th $50–$2040%10%10th90th$85$10.0$20.0$50.0$100.0$200.0$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
$51.29 / $72.44 / $323.59
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$107.15 / $245.47 / $354.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $79.43 / $194.98
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$53.70 / $91.20 / $223.87
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $100.00 / $158.49
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $83.18 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $147.91 / $173.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $91.20 / $162.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $81.28 / $141.25
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$89.13 / $91.20 / $144.54