What does Independence Blue Cross (PA) pay for CPT 99214 in Philadelphia-Camden-Wilmington, PA-NJ-DE-MD?

The local peer median for CPT 99214 under Independence Blue Cross (PA) in Philadelphia-Camden-Wilmington, PA-NJ-DE-MD is $106, based on 4350 indexed providers. Modeled from published rates, not guaranteed.

What is the top of the local market (P90) for CPT 99214 under Independence Blue Cross (PA) in Philadelphia-Camden-Wilmington, PA-NJ-DE-MD?

The P90, the top of the local market and Reddenda's target rate, is $137.52.

How does Independence Blue Cross (PA)'s rate for CPT 99214 compare to Medicare?

The Independence Blue Cross (PA) local median of $106 is 78% of Medicare's national non-facility rate of $135.61 for CPT 99214.

Reddenda · Rate Intelligence · Philadelphia-Camden-Wilmington, PA-NJ-DE-MD

99214 under Independence Blue Cross (PA) in Philadelphia-Camden-Wilmington, PA-NJ-DE-MD

Name: Independence Blue Cross (PA) rates for CPT 99214 in Philadelphia-Camden-Wilmington, PA-NJ-DE-MD
Creator: Reddenda

Office visit, established patient, 30-39 min · Local peer median $106 · High confidence

$106 local peer median. In the Philadelphia-Camden-Wilmington, PA-NJ-DE-MD market, Independence Blue Cross (PA) pays a local peer median of $106 for CPT 99214 (Office visit, established patient, 30-39 min), based on 4350 providers in Reddenda's index of Independence Blue Cross (PA)'s own published in-network rates. The top of the local market, the P90 target, is $137.52, 30% above the median. A provider billed below the local median is being paid less than peers holding the identical Independence Blue Cross (PA) contract in Philadelphia-Camden-Wilmington, PA-NJ-DE-MD for the identical code. Modeled from published rates, not guaranteed.

Local distribution · 4350 providers · 5104 rate records

P10

$76.21

P25

$100.58

Median

$106

P75

$124.71

P90 (target)

$137.52

P10$76.21

P25$100.58

Median (P50)$106

P75$124.71

P90 target$137.52

Peer basis: local peer distribution: same CPT, same payer file, same metro (CBSA) Benchmark: local peer median; never a national average Range: $57 – $1,056

The local peer median for CPT 99214 under Independence Blue Cross (PA) in Philadelphia-Camden-Wilmington, PA-NJ-DE-MD is $106, drawn from 4350 distinct providers.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Independence Blue Cross (PA) to publish this rate
The bottom of the local market (P10) is $76.21 and the top (P90) is $137.52; the median-to-P90 spread is $31.52.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Independence Blue Cross (PA) to publish this rate
The lowest published rate in this market is $57; the highest is $1,056.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Independence Blue Cross (PA) to publish this rate
This benchmark is drawn from 5104 individual rate records that Independence Blue Cross (PA) itself published for this code in this metro.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Independence Blue Cross (PA) to publish this rate
Medicare's national non-facility rate for CPT 99214 is $135.61, making the Independence Blue Cross (PA) local median 78% of Medicare.Source: Medicare Physician Fee Schedule; the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Independence Blue Cross (PA) to publish this rate
25% of indexed providers cluster at the single most common rate; the remainder shows a real, scoreable spread across the local market.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Independence Blue Cross (PA) to publish this rate
A federal No Surprises Act arbitrator may weigh up to four plan years of a provider's own contracted rate history and local market share when resolving a payment dispute over this exact code and payer.Source: 45 CFR §149.510(c)(4)(iii)(B)

4350 providers bill this code to this payer in this metro.

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This is the local market for CPT 99214 (Office visit, established patient, 30-39 min) under Independence Blue Cross (PA) in Philadelphia-Camden-Wilmington, PA-NJ-DE-MD. Enter your NPI to see your own contracted rate against this peer curve, per payer and per code. Free, about 15 seconds, no card and no PHI.

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Documented reimbursement opportunity, modeled from published rates and never a guaranteed outcome.

Modeled from Independence Blue Cross (PA)'s own published in-network rates, never guaranteed and never a national average. Peer basis: same CPT, same payer file, same metro (CBSA). Federal citation for the underlying obligation: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Independence Blue Cross (PA) to publish this rate. Page generated 2026-08-23 22:49 UTC; the live index is queried in real time on every request.