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Kentucky 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 $89 · 10th–90th $63–$1510%10%20%10th90th$89Professionalmedian $117 · 10th–90th $60–$2630%5%10%10th90th$117$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
$63.10 / $85.11 / $134.90
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$51.29 / $89.13 / $851.14
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $114.82 / $257.04
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$60.26 / $120.23 / $269.15
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $117.49 / $162.18
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$89.13 / $125.89 / $169.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $77.62 / $125.89
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $104.71 / $147.91
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $138.04 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $151.36 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $114.82 / $602.56
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $47.86 / $131.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $93.33 / $162.18
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $114.82 / $181.97