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Pennsylvania 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 $331 · 10th–90th $41$2,9510%20%10th90th$331Professionalmedian $48 · 10th–90th $33$1320%20%10th90th$48$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$40.74 / $331.13 / $2,951.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $44.67 / $138.04
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
$38.02 / $58.88 / $97.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $54.95 / $89.13
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $64.57 / $83.18
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $57.54 / $95.50
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $41.69 / $331.13
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $41.69 / $60.26
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $100.00 / $131.83
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.42 / $40.74 / $138.04
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $52.48 / $114.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $54.95 / $93.33