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Vermont 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 $234 · 10th–90th $91–$3980%20%10th90th$234Professionalmedian $110 · 10th–90th $65–$2400%5%10%10th90th$110$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $234.42 / $234.42
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $102.33 / $229.09
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$69.18 / $125.89 / $251.19
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $169.82 / $169.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $114.82 / $199.53
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $147.91 / $229.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $72.44 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $120.23 / $257.04
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $154.88 / $181.97