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Washington 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 $178 · 10th–90th $105–$3800%10%10th90th$178Professionalmedian $186 · 10th–90th $93–$5010%5%10th90th$186$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
$141.25 / $204.17 / $416.87
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$97.72 / $288.40 / $776.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $173.78 / $489.78
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$109.65 / $223.87 / $524.81
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $218.78 / $354.81
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$154.88 / $204.17 / $371.54
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $257.04 / $407.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $147.91 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $204.17 / $436.52
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $162.18 / $346.74
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $154.88 / $338.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $89.13 / $194.98
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $275.42 / $354.81
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $239.88
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $245.47 / $446.68
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $263.03 / $398.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $87.10 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $186.21 / $331.13
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$89.13 / $123.03 / $346.74
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $194.98 / $275.42