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Maine 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 $132 · 10th–90th $56–$5250%10%10th90th$132Professionalmedian $107 · 10th–90th $54–$2750%10%20%10th90th$107$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$50.12 / $112.20 / $316.23
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$69.18 / $229.09 / $524.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $104.71 / $251.19
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$58.88 / $117.49 / $302.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $134.90 / $213.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $120.23 / $245.47
Community Health Options
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $194.98 / $257.04
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $177.83 / $331.13
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $95.50 / $169.82
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $100.00 / $186.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $147.91 / $257.04
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$60.26 / $165.96 / $251.19