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Indiana 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 $98 · 10th–90th $58–$2400%5%10%10th90th$98Professionalmedian $115 · 10th–90th $59–$2510%5%10%10th90th$115$1.0$5.0$20.0$100.0$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
$57.54 / $97.72 / $190.55
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$57.54 / $102.33 / $436.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $109.65 / $251.19
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$60.26 / $117.49 / $251.19
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$91.20 / $173.78 / $309.03
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $117.49 / $173.78
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $125.89 / $177.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $112.20 / $173.78
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $114.82 / $141.25
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $141.25 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $114.82 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $112.20 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $85.11 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $100.00 / $177.83
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $123.03 / $204.17