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Missouri 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 $126 · 10th–90th $78–$3550%5%10%10th90th$126Professionalmedian $120 · 10th–90th $59–$2950%5%10%10th90th$120$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
$77.62 / $123.03 / $346.74
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$91.20 / $316.23 / $616.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $117.49 / $281.84
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$60.26 / $123.03 / $309.03
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $112.20 / $165.96
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$95.50 / $123.03 / $162.18
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $104.71 / $151.36
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $125.89 / $162.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $147.91 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $117.49 / $199.53
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $114.82 / $208.93
Medica
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$25.12 / $25.12 / $537.03
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $147.91 / $794.33
Medica
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$109.65 / $138.04 / $181.97
Qualchoice
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $141.25 / $208.93
Qualchoice
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$95.50 / $141.25 / $194.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $69.18 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $102.33 / $177.83
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $89.13 / $199.53