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Ohio 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 $91 · 10th–90th $47$1550%20%10th90th$91Professionalmedian $120 · 10th–90th $60$2820%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
$46.77 / $89.13 / $154.88
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$46.77 / $91.20 / $263.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $117.49 / $275.42
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$61.66 / $125.89 / $309.03
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$95.50 / $234.42 / $707.95
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
$87.10 / $125.89 / $169.82
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
$61.66 / $87.10 / $151.36
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $125.89 / $181.97
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $104.71 / $151.36
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $131.83 / $257.04
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $131.83 / $165.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $120.23 / $208.93
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $128.82 / $181.97
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $134.90 / $186.21
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $77.62
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $123.03 / $208.93
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $128.82 / $177.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $81.28 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $102.33 / $190.55
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $125.89 / $194.98