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Montana 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 $224 · 10th–90th $126–$3160%10%10th90th$224Professionalmedian $182 · 10th–90th $89–$4370%5%10th90th$182$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
$173.78 / $316.23 / $398.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $173.78 / $426.58
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$89.13 / $194.98 / $457.09
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $239.88 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $223.87 / $281.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $169.82 / $316.23
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $245.47 / $316.23
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $245.47 / $316.23
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $169.82 / $302.00
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $257.04 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $190.55 / $263.03