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Vermont 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 $135 · 10th–90th $105–$2000%20%10th90th$135Professionalmedian $155 · 10th–90th $93–$3390%10%10th90th$155$10.0$20.0$50.0$100.0$200.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $134.90 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $147.91 / $323.59
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$95.50 / $190.55 / $380.19
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $234.42 / $234.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $162.18 / $269.15
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $199.53 / $316.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $104.71 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $162.18 / $346.74