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New Jersey rates for HCPCS 99417

Prolonged outpatient evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (List separately in addition to the code of the outpatient Evaluation and Management service)

Facilitymedian $87 · 10th–90th $25–$3800%20%10th90th$87Professionalmedian $41 · 10th–90th $23–$2040%10%20%10th90th$41$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
$25.12 / $87.10 / $380.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $41.69 / $218.78
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $29.51 / $42.66
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $512.86 / $1,023.29
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $45.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $43.65 / $64.57
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $16.22 / $58.88
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $33.11 / $60.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27.54 / $27.54 / $33.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $35.48 / $61.66