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Vermont 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 $331 · 10th–90th $87–$4470%10%20%10th90th$331Professionalmedian $81 · 10th–90th $51–$1660%10%10th90th$81$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
$75.86 / $436.52 / $446.68
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$112.20 / $331.13 / $331.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $75.86 / $162.18
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$54.95 / $89.13 / $173.78
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $120.23 / $120.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $77.62 / $131.83
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $100.00 / $162.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $45.71 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $87.10 / $190.55
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$104.71 / $104.71 / $128.82