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Michigan 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 $155 · 10th–90th $85–$3890%10%10th90th$155Professionalmedian $174 · 10th–90th $95–$4270%5%10%10th90th$174$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
$85.11 / $147.91 / $275.42
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$93.33 / $263.03 / $398.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $165.96 / $407.38
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$104.71 / $204.17 / $457.09
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $169.82 / $251.19
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $181.97 / $275.42
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $158.49 / $234.42
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $173.78 / $229.09
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $181.97 / $245.47
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $223.87 / $398.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $147.91
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $154.88 / $338.84
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $147.91 / $239.88
Health Alliance Plan
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$93.33 / $263.03 / $398.11
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $154.88 / $331.13
Health Alliance Plan
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$100.00 / $199.53 / $436.52
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $147.91
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $144.54 / $234.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $117.49 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $147.91 / $309.03
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $173.78 / $346.74