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Virginia 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 $151 · 10th–90th $102–$2570%20%10th90th$151Professionalmedian $170 · 10th–90th $95–$3890%10%20%10th90th$170$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
$81.28 / $125.89 / $223.87
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$151.36 / $194.98 / $2,511.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $158.49 / $371.54
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$95.50 / $190.55 / $436.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $208.93 / $331.13
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $120.23 / $199.53
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $151.36 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $162.18 / $288.40
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $213.80 / $323.59
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $154.88 / $208.93
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $162.18 / $263.03
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $269.15
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $141.25 / $234.42
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $177.83 / $295.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $104.71 / $154.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $141.25 / $257.04
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$75.86 / $95.50 / $407.38