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Massachusetts 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 $166 · 10th–90th $89–$3890%5%10%10th90th$166Professionalmedian $186 · 10th–90th $95–$4680%5%10th90th$186$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
$107.15 / $181.97 / $371.54
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$138.04 / $275.42 / $954.99
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $173.78 / $446.68
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$104.71 / $208.93 / $512.86
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $478.63 / $912.01
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $190.55 / $524.81
AllWays Health Partners
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $114.82 / $223.87
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $213.80 / $371.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $281.84 / $389.05
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $194.98 / $263.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $181.97 / $354.81
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $107.15 / $194.98
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $165.96 / $302.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $263.03 / $467.74
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $204.17 / $251.19
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $263.03 / $870.96
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $478.63 / $912.01
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $190.55 / $524.81
Mass General Brigham
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $114.82 / $223.87
Tufts
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $97.72 / $151.36
Tufts
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $144.54 / $323.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $177.83 / $213.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $194.98 / $446.68
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$83.18 / $218.78 / $346.74