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West 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 $81 · 10th–90th $41–$1950%10%10th90th$81Professionalmedian $85 · 10th–90th $50–$1620%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
$40.74 / $69.18 / $138.04
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$30.20 / $117.49 / $257.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $79.43 / $158.49
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$53.70 / $87.10 / $165.96
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $74.13 / $104.71
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $91.20 / $199.53
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $134.90
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 / $85.11 / $275.42
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $91.20
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $95.50 / $112.20
Highmark BCBS
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $95.50 / $151.36
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
$40.74 / $67.61 / $107.15
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $104.71 / $141.25