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Wisconsin 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 $186 · 10th–90th $105–$5620%10%20%10th90th$186Professionalmedian $191 · 10th–90th $102–$4790%10%10th90th$191$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
$93.33 / $186.21 / $575.44
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$128.82 / $363.08 / $2,041.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $169.82 / $478.63
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$117.49 / $239.88 / $512.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $218.78 / $407.38
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $173.78 / $251.19
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $213.80 / $398.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $562.34 / $776.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $281.84 / $524.81
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $154.88 / $281.84
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $331.13 / $457.09
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $154.88 / $338.84
Medica
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $338.84 / $1,122.02
Medica
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$295.12 / $398.11 / $478.63
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $186.21
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $223.87 / $380.19
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $316.23 / $478.63
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $269.15 / $912.01
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $263.03 / $1,122.02
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $213.80
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $269.15 / $371.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $131.83 / $144.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $331.13 / $478.63
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $95.50 / $323.59