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Utah 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 $288 · 10th–90th $115–$4270%20%10th90th$288Professionalmedian $129 · 10th–90th $51–$3390%5%10th90th$129$5.0$10.0$20.0$50.0$100.0$200.0$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
$114.82 / $288.40 / $426.58
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$147.91 / $165.96 / $467.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $125.89 / $331.13
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$54.95 / $131.83 / $363.08
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $165.96 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $114.82 / $218.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $131.83
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $131.83 / $177.83
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $134.90 / $281.84
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $141.25 / $263.03
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
$72.44 / $109.65 / $177.83
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $89.13 / $158.49