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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
$57.89 / $90.10 / $126.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.34 / $83.93 / $140.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.67 / $61.67 / $68.36
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.41 / $72.20 / $107.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.68 / $73.68 / $73.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.93 / $95.36 / $150.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.70 / $99.79 / $165.33