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Georgia 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 $115–$2,0420%10%10th90th$263Professionalmedian $170 · 10th–90th $100–$3720%10%20%10th90th$170$1.0$5.0$20.0$100.0$500.0$2.0K$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
$112.20 / $269.15 / $3,090.30
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$131.83 / $467.74 / $741.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $165.96 / $363.08
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$102.33 / $181.97 / $416.87
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $186.21 / $302.00
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$141.25 / $194.98 / $302.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $151.36 / $275.42
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $194.98 / $275.42
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $213.80 / $275.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $141.25 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $162.18 / $295.12
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $204.17 / $331.13
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $234.42 / $354.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $134.90 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $147.91 / $257.04
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $89.13 / $346.74