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Tennessee 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 $54–$3090%10%10th90th$93Professionalmedian $83 · 10th–90th $51–$1780%10%10th90th$83$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 / $93.33 / $302.00
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$67.61 / $138.04 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $81.28 / $169.82
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$53.70 / $87.10 / $199.53
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$263.03 / $263.03 / $263.03
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $85.11 / $125.89
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $89.13 / $131.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $85.11 / $138.04
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $120.23 / $208.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $75.86 / $131.83
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $630.96
Lucent Health
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Lucent Health
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$41.69 / $41.69 / $41.69
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $562.34 / $562.34
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $85.11 / $120.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $45.71 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $70.79 / $114.82
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $89.13 / $114.82