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Utah 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 $191 · 10th–90th $71–$2290%10%10th90th$191Professionalmedian $91 · 10th–90th $48–$2290%10%10th90th$91$5.0$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
$70.79 / $107.15 / $229.09
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$131.83 / $190.55 / $371.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $89.13 / $218.78
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$43.65 / $91.20 / $239.88
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$257.04 / $269.15 / $269.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $120.23 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $77.62 / $154.88
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $85.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $89.13 / $117.49
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $95.50 / $186.21
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $97.72 / $169.82
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
$47.86 / $77.62 / $125.89
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $89.13 / $141.25