price transparency

CPT Codes Charged Amount Commercial Average Reimbursement MN MA Average Reimbursement
Outpatient office visits for established patients, by level of complexity
99211 $62.78 $50.46 $17.83
99212 $124.57 $100.14 $34.83
99213 $205.00 $164.80 $57.69
99214 $300.15 $241.28 $83.61
99215 $402.16 $323.29 $112.31
Outpatient office visits for new patients, by level of complexity
99201 $126.53 $101.72 $35.11
99202 $210.89 $169.53 $58.24
99203 $299.17 $240.49 $82.79
99204 $454.15 $365.08 $125.69
99205 $570.87 $458.91 $158.58
Periodic preventive medicine for established patients, by age
12-17 Years 99394 $322.71 $259.42 $90.02
18-39 Years 99395 $329.57 $264.94 $92.24
40-64 Years 99396 $351.15 $282.28 $98.10
65 and Olds 99397 $377.64 $303.57 $105.34
Periodic preventive medicine for new patients, by age
12-17 Years 99385 $377.64 $303.57 $105.34
18-39 Years 99385 $364.89 $293.32 $102.28
40-64 Years 99386 $423.74 $340.63 $118.16
65 and Olds 99387 $459.05 $369.02 $128.20
Other Common Services
IUD Insertion 58300 $223.64 $179.78 $65.68
IUD Removal 58301 $264.84 $212.90 $71.84
Admin of Injection 96372 $69.80 $37.06 $10.00
Admin of Vaccine 90471 $69.80 $37.06 $10.86
Tdap 90715 $68.06 $33.64 $33.63
HPV vaccine 90651 $410.50 $232.36 $273.37
DEXA 77080 $112.75 $89.10 $28.22