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Pennsylvania rates for HCPCS G2211

Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to home or residence or office/outpatient evaluation and management service, new or established)

Facilitymedian $66 · 10th–90th $66–$2950%50%90th$66Professionalmedian $16 · 10th–90th $3–$550%20%10th90th$16$0.0$0.1$0.5$2.0$10.0$50.0$200.0

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
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $66.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.39 / $16.22 / $54.95
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $17.38 / $30.20
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $28.18 / $28.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.80 / $13.80 / $13.80
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $28.84
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $15.85 / $28.84
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $15.14 / $28.84
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $21.88 / $33.88
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $15.14
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $218.78 / $309.03
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $15.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.45 / $19.50 / $30.90