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New Jersey 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 $141 · 10th–90th $65–$5370%5%10%10th90th$141Professionalmedian $170 · 10th–90th $89–$3800%5%10%10th90th$170$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
$64.57 / $120.23 / $537.03
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$123.03 / $489.78 / $537.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $162.18 / $371.54
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$91.20 / $190.55 / $436.52
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $165.96 / $223.87
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$134.90 / $173.78 / $213.80
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $144.54 / $309.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $173.78 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $169.82 / $309.03
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $75.86 / $323.59
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $173.78 / $275.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $190.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $141.25 / $288.40
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $95.50 / $407.38