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Alabama 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.

Facilitymedian $95 · 10th–90th $52–$1290%10%20%10th90th$95Professionalmedian $83 · 10th–90th $48–$1410%5%10%10th90th$83$5.0$10.0$20.0$50.0$100.0$200.0$500.0

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
$52.48 / $95.50 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $85.11 / $141.25
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $72.44 / $154.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $89.13 / $114.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $89.13 / $147.91
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $100.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $75.86 / $117.49