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Nationwide rates for HCPCS 99242

Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.65 / $79.43 / $138.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $87.10 / $158.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $64.57 / $72.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $67.61 / $128.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.79 / $85.11 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $93.33 / $158.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $72.44 / $95.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $87.10 / $147.91