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Pennsylvania 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)

Facilitymedian $29 · 10th–90th $28–$480%50%10th90th$29Professionalmedian $35 · 10th–90th $26–$1050%20%10th90th$35$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
$28.18 / $28.84 / $34.67
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $34.67 / $109.65
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$50.12 / $77.62 / $478.63
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $30.90 / $51.29
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$31.62 / $31.62 / $60.26
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
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
$28.18 / $33.11 / $51.29
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $47.86 / $47.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $31.62 / $31.62
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $61.66
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $48.98 / $69.18
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $37.15 / $61.66
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $34.67 / $52.48
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $151.36
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $28.18 / $28.84
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $34.67 / $69.18
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $36.31 / $42.66
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $36.31
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $45.71 / $64.57
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.08 / $31.62 / $54.95
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $31.62 / $37.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $37.15 / $63.10