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Pennsylvania rates for HCPCS 99443

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; 21-30 minutes of medical discussion

Facilitymedian $123 · 10th–90th $81–$7940%20%40%10th90th$123Professionalmedian $123 · 10th–90th $72–$2450%10%10th90th$123$10.0$20.0$50.0$100.0$200.0$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
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $380.19 / $549.54
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $109.65 / $158.49
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $154.88 / $245.47
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $117.49 / $794.33
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $123.03 / $416.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $93.33 / $245.47