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Ohio 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 $112 · 10th–90th $47$2400%20%10th90th$112Professionalmedian $174 · 10th–90th $95$4070%10%10th90th$174$1.0$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
$46.77 / $112.20 / $239.88
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$45.71 / $95.50 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $165.96 / $389.05
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$104.71 / $199.53 / $457.09
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $169.82 / $234.42
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $177.83 / $234.42
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $131.83 / $218.78
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $186.21 / $275.42
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $154.88 / $223.87
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $186.21 / $363.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $131.83 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $169.82 / $302.00
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $128.82 / $223.87
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $190.55 / $269.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $104.71
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $169.82 / $295.12
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $194.98 / $269.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $120.23 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $141.25 / $269.15
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $95.50 / $239.88