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Virginia 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 $107 · 10th–90th $62–$2000%10%20%10th90th$107Professionalmedian $115 · 10th–90th $59–$2690%10%10th90th$115$1.0$5.0$20.0$100.0$500.0$2.0K

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
$48.98 / $91.20 / $251.19
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$48.98 / $147.91 / $323.59
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $109.65 / $263.03
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$60.26 / $123.03 / $281.84
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$95.50 / $234.42 / $309.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $144.54 / $234.42
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $81.28 / $134.90
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $151.36 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $117.49 / $204.17
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $151.36 / $229.09
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $114.82 / $154.88
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $117.49 / $190.55
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $186.21
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $97.72 / $158.49
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $128.82 / $208.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $77.62 / $107.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $100.00 / $181.97
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$75.86 / $107.15 / $199.53