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Massachusetts 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 $123 · 10th–90th $56–$2880%5%10%10th90th$123Professionalmedian $126 · 10th–90th $58–$3090%5%10th90th$126$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
$75.86 / $138.04 / $275.42
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$138.04 / $275.42 / $933.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $120.23 / $295.12
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$58.88 / $128.82 / $331.13
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$95.50 / $309.03 / $309.03
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $323.59 / $630.96
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $141.25 / $371.54
AllWays Health Partners
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$51.29 / $77.62 / $158.49
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $154.88 / $251.19
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $190.55 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $194.98 / $263.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $128.82 / $251.19
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $72.44 / $134.90
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $117.49 / $213.80
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $181.97 / $331.13
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $141.25 / $407.38
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $199.53 / $562.34
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $323.59 / $630.96
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $141.25 / $371.54
Mass General Brigham
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$51.29 / $77.62 / $158.49
Tufts
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $56.23 / $128.82
Tufts
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $102.33 / $229.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $74.13 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $141.25 / $316.23
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $89.13 / $204.17