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Michigan 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 $110 · 10th–90th $65$3240%10%10th90th$110Professionalmedian $123 · 10th–90th $62$2880%5%10%10th90th$123$2.0$10.0$50.0$200.0

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
$75.86 / $107.15 / $218.78
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$61.66 / $223.87 / $416.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $120.23 / $281.84
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$63.10 / $128.82 / $302.00
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$95.50 / $295.12 / $302.00
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $114.82 / $165.96
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$83.18 / $125.89 / $173.78
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $123.03 / $181.97
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $134.90 / $199.53
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $123.03 / $165.96
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $158.49 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $147.91
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $109.65 / $245.47
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $107.15 / $165.96
Health Alliance Plan
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$61.66 / $218.78 / $331.13
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $109.65 / $251.19
Health Alliance Plan
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$63.10 / $128.82 / $302.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$295.12 / $295.12 / $302.00
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $147.91
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $102.33 / $169.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $87.10 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $104.71 / $213.80
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $120.23 / $199.53