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Illinois rates for HCPCS 99214

Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.

Facilitymedian $186 · 10th–90th $65–$3310%10%20%10th90th$186Professionalmedian $120 · 10th–90th $60–$2820%10%10th90th$120$2.0$10.0$50.0$200.0$1.0K

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
$61.66 / $151.36 / $323.59
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$91.20 / $218.78 / $331.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $117.49 / $275.42
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$61.66 / $123.03 / $302.00
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$91.20 / $95.50 / $234.42
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $120.23 / $169.82
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$89.13 / $128.82 / $177.83
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $169.82 / $331.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $117.49 / $144.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $134.90 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $128.82 / $213.80
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $158.49 / $269.15
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $144.54 / $169.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $173.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $125.89 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $128.82 / $245.47
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $107.15 / $204.17