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Pennsylvania rates for HCPCS G0463

Hospital outpatient clinic visit for assessment and management of a patient

Facilitymedian $129 · 10th–90th $44$3630%5%10%10th90th$129Professionalmedian $87 · 10th–90th $74$1170%50%10th90th$87$1.0$10.0$100.0$1.0K$10.0K

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
$42.66 / $128.82 / $363.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $87.10 / $120.23
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $66.07
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,511.38 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $107.15 / $112.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $97.72
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $263.03 / $436.52
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $138.04 / $812.83
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $125.89 / $446.68
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $87.10 / $117.49
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $199.53 / $346.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $50.12