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California 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 $158 · 10th–90th $102–$3980%10%20%10th90th$158Professionalmedian $195 · 10th–90th $105–$5130%10%10th90th$195$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
$109.65 / $204.17 / $446.68
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$77.62 / $199.53 / $741.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $190.55 / $501.19
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$112.20 / $218.78 / $524.81
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $181.97 / $302.00
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$141.25 / $186.21 / $295.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $120.23 / $131.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $147.91 / $263.03
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $89.13
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $169.82 / $363.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $151.36 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $169.82 / $323.59
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $141.25 / $281.84
HealthNet
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $426.58 / $741.31
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $199.53 / $338.84
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $912.01
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $295.12 / $1,122.02
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $77.62 / $724.44
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $181.97 / $288.40
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $165.96 / $281.84
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $177.83 / $380.19
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $380.19
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $107.15 / $213.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $181.97 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $141.25 / $288.40
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $95.50 / $257.04