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Illinois 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 $209 · 10th–90th $105–$4570%10%10th90th$209Professionalmedian $178 · 10th–90th $95–$4170%5%10%10th90th$178$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
$102.33 / $186.21 / $407.38
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$128.82 / $398.11 / $776.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $169.82 / $407.38
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$100.00 / $194.98 / $457.09
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $173.78 / $245.47
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$131.83 / $181.97 / $245.47
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $239.88 / $489.78
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $169.82 / $204.17
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $144.54 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $181.97 / $295.12
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $229.09 / $398.11
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $204.17 / $239.88
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $213.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $173.78 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $190.55 / $346.74
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $95.50 / $346.74