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Utah 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 $324 · 10th–90th $141–$5620%10%20%10th90th$324Professionalmedian $182 · 10th–90th $76–$5010%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
$128.82 / $380.19 / $562.34
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$218.78 / $218.78 / $218.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $173.78 / $489.78
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$77.62 / $199.53 / $524.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $162.18 / $309.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $186.21
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $181.97 / $257.04
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $190.55 / $380.19
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $194.98 / $354.81
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
$97.72 / $151.36 / $251.19
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13