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Wisconsin 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 $33 · 10th–90th $24–$720%10%20%10th90th$33Professionalmedian $58 · 10th–90th $23–$2750%5%10th90th$58$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
$21.88 / $30.20 / $57.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $54.95 / $323.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $42.66 / $81.28
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $35.48 / $51.29
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $37.15 / $69.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $95.50 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $57.54 / $89.13
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $31.62 / $57.54
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $64.57 / $85.11
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $32.36 / $61.66
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $61.66 / $194.98
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $50.12 / $70.79
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $42.66 / $79.43
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $63.10 / $95.50
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $56.23 / $190.55
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $50.12 / $194.98
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $37.15
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $52.48 / $63.10
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $43.65 / $43.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $75.86 / $104.71