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Nationwide rates for HCPCS 99215

Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.

Facilitymedian $170 · 10th–90th $98$4370%10%10th90th$170Professionalmedian $174 · 10th–90th $95$4270%10%10th90th$174$0.1$1.0$10.0$100.0$1.0K$10.0K

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
$91.20 / $158.49 / $426.58
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$97.72 / $309.03 / $741.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $165.96 / $407.38
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$100.00 / $199.53 / $467.74
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $120.23 / $131.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $141.25 / $257.04
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $158.49 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $169.82 / $338.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $125.89 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $151.36 / $354.81
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $95.50 / $346.74