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Delaware 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 $200 · 10th–90th $115–$3800%10%20%10th90th$200Professionalmedian $162 · 10th–90th $95–$3550%10%10th90th$162$5.0$20.0$100.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $154.88 / $338.84
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$316.23 / $338.84 / $489.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $151.36 / $338.84
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$107.15 / $190.55 / $436.52
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $131.83 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $151.36 / $288.40
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $208.93 / $331.13
Highmark BCBS
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$158.49 / $186.21 / $338.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $131.83 / $245.47
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13