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New York rates for HCPCS 99415

Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; first hour (List separately in addition to code for outpatient Evaluation and Management service)

Facilitymedian $26 · 10th–90th $7–$4790%10%10th90th$26Professionalmedian $19 · 10th–90th $8–$440%10%20%10th90th$19$0.1$0.5$2.0$10.0$50.0$200.0

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
$7.94 / $34.67 / $512.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $9.33 / $27.54
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$18.62 / $18.62 / $18.62
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $19.95 / $23.44
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$23.44 / $23.44 / $23.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $23.44 / $23.44
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.80 / $13.80 / $13.80
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.80 / $13.80 / $13.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $32.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.55 / $16.22 / $43.65
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.10 / $0.10 / $24.55
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $33.11 / $47.86
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $19.05 / $22.39
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $22.39 / $50.12
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $12.59 / $12.59
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.48 / $13.80 / $45.71
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.23 / $12.88 / $21.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.71 / $9.33 / $10.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $31.62 / $45.71
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.24 / $14.45 / $20.89
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $22.39 / $40.74