go back

New Jersey 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 $129 · 10th–90th $52–$3390%10%10th90th$129Professionalmedian $115 · 10th–90th $55–$2630%10%10th90th$115$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$51.29 / $114.82 / $338.84
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$64.57 / $154.88 / $446.68
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $109.65 / $263.03
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$60.26 / $120.23 / $288.40
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $117.49 / $162.18
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$81.28 / $123.03 / $165.96
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $169.82 / $6,025.60
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $107.15 / $208.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $169.82 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $123.03 / $218.78
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $46.77 / $223.87
Emblem Health
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$46.77 / $46.77 / $46.77
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $128.82 / $204.17
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $134.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $100.00 / $204.17
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $128.82 / $194.98