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Ohio rates for HCPCS 99359

Prolonged evaluation and management service before and/or after direct patient care; each additional 30 minutes (List separately in addition to code for prolonged service)

Facilitymedian $37 · 10th–90th $29–$1580%10%20%10th90th$37Professionalmedian $46 · 10th–90th $29–$850%10%20%10th90th$46$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
$28.84 / $37.15 / $158.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $42.66 / $91.20
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $32.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $52.48 / $83.18
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$29.51 / $34.67 / $40.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $56.23 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $50.12 / $91.20
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $56.23 / $56.23
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $50.12 / $91.20
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
$33.88 / $43.65 / $75.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $54.95 / $85.11