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Texas 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 $162 · 10th–90th $115$4170%10%20%10th90th$162Professionalmedian $155 · 10th–90th $98$3630%10%20%10th90th$155$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$114.82 / $151.36 / $524.81
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$95.50 / $380.19 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $154.88 / $354.81
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$102.33 / $190.55 / $446.68
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $169.82 / $229.09
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$123.03 / $181.97 / $223.87
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $154.88 / $398.11
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $120.23 / $162.18
Baylor Scott & White
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $144.54 / $467.74
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $190.55 / $309.03
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $151.36 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $173.78 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $162.18 / $281.84
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $912.01 / $912.01
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $213.80 / $1,122.02
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $158.49 / $281.84
Moda Health
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$95.50 / $371.54 / $501.19
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $144.54 / $263.03
Moda Health
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$102.33 / $186.21 / $426.58
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $46.77 / $87.10
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $281.84 / $691.83
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $158.49 / $281.84
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $165.96 / $323.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $138.04 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $138.04 / $223.87
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$83.18 / $89.13 / $218.78
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $186.21 / $208.93