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Montana 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 $155 · 10th–90th $83–$2240%10%10th90th$155Professionalmedian $123 · 10th–90th $55–$3090%5%10th90th$123$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
$19.50 / $128.82 / $316.23
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$112.20 / $112.20 / $354.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $120.23 / $295.12
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$60.26 / $131.83 / $323.59
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $173.78 / $204.17
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $151.36 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $123.03 / $229.09
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $173.78 / $223.87
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $173.78 / $223.87
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $120.23 / $218.78
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $181.97 / $338.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $134.90 / $194.98
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $85.11 / $204.17