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Ohio rates for HCPCS 99358

Prolonged evaluation and management service before and/or after direct patient care; first hour

Facilitymedian $83 · 10th–90th $68–$2820%10%20%10th90th$83Professionalmedian $100 · 10th–90th $69–$2000%10%10th90th$100$1.0$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
$67.61 / $83.18 / $281.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $91.20 / $223.87
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $93.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $114.82 / $177.83
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $85.11 / $100.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $117.49 / $186.21
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $114.82 / $186.21
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $104.71 / $177.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $114.82 / $177.83