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Washington, DC 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 $263 · 10th–90th $123–$3630%10%10th90th$263Professionalmedian $170 · 10th–90th $87–$3800%5%10%10th90th$170$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
$123.03 / $263.03 / $363.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $165.96 / $371.54
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$91.20 / $190.55 / $416.87
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $117.49 / $165.96
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
$112.20 / $158.49 / $309.03
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $213.80 / $323.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $114.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $144.54 / $281.84
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$89.13 / $323.59 / $346.74