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Wisconsin rates for HCPCS 99442

Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion

Facilitymedian $263 · 10th–90th $27–$4070%10%10th90th$263Professionalmedian $123 · 10th–90th $30–$4370%5%10th90th$123$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $100.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $281.84 / $457.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $186.21 / $263.03
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $263.03
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $562.34 / $562.34
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $58.88
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $407.38
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $562.34 / $562.34
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.42 / $23.44 / $72.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $67.61 / $128.82