go back

Pennsylvania rates for HCPCS 99358

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

Facilitymedian $186 · 10th–90th $83$1,4790%20%10th90th$186Professionalmedian $102 · 10th–90th $78$3470%20%10th90th$102$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$83.18 / $186.21 / $1,479.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $97.72 / $363.08
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $44.67
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $128.82 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $120.23 / $186.21
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $151.36 / $323.59
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $125.89 / $213.80
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $114.82
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $87.10 / $331.13
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $95.50 / $199.53
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $204.17 / $234.42
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $70.79 / $123.03
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $79.43 / $109.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $114.82 / $204.17