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Washington 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 $132 · 10th–90th $74–$2820%5%10%10th90th$132Professionalmedian $129 · 10th–90th $55–$3390%5%10th90th$129$2.0$10.0$50.0$200.0$1.0K

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
$93.33 / $144.54 / $281.84
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$87.10 / $257.04 / $602.56
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $123.03 / $331.13
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$56.23 / $138.04 / $363.08
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$91.20 / $95.50 / $95.50
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $141.25 / $245.47
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$107.15 / $151.36 / $257.04
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $181.97 / $288.40
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $147.91 / $165.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $138.04 / $295.12
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $114.82 / $251.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $114.82 / $234.42
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $64.57 / $141.25
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $213.80 / $251.19
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $169.82
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $169.82 / $316.23
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $181.97 / $275.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $64.57 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $131.83 / $239.88
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $95.50 / $199.53
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $138.04 / $194.98