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Kentucky 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 $129 · 10th–90th $93–$1950%20%10th90th$129Professionalmedian $170 · 10th–90th $95–$3800%10%20%10th90th$170$1.0$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
$93.33 / $123.03 / $158.49
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$194.98 / $575.44 / $575.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $162.18 / $371.54
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$107.15 / $190.55 / $446.68
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $169.82 / $229.09
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$138.04 / $181.97 / $239.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $120.23 / $173.78
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $154.88 / $218.78
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $194.98 / $263.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $223.87 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $169.82 / $851.14
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $67.61 / $165.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $128.82 / $223.87
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $89.13 / $218.78