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Maine rates for HCPCS G2212

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified health care professional, with or without direct patient contact (list separately in addition to CPT codes 99205, 99215, 99483 for office or other outpatient evaluation and management services.) (Do not report G2212 on the same date of service as codes 99358, 99359, 99415, 99416). (Do not report G2212 for any time unit less than 15 minutes)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.68 / $27.68 / $28.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.67 / $29.82 / $50.14
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.21 / $38.50 / $59.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.14 / $41.14 / $41.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.57 / $28.57 / $28.57
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.54 / $45.78 / $78.47
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.67 / $32.10 / $53.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.95 / $48.05 / $70.23