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Virginia 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 $74 · 10th–90th $45–$1450%10%20%10th90th$74Professionalmedian $85 · 10th–90th $50–$1820%20%10th90th$85$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
$38.90 / $63.10 / $186.21
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$72.44 / $117.49 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $81.28 / $177.83
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$52.48 / $87.10 / $194.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $100.00 / $162.18
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $53.70 / $93.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $141.25 / $204.17
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 / $79.43 / $138.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $107.15 / $158.49
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $75.86 / $104.71
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $79.43 / $128.82
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $120.23
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $64.57 / $107.15
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $89.13 / $147.91
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$37.15 / $52.48 / $69.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $69.18 / $120.23
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $93.33 / $138.04