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Outpatient Specialist Consultation Visit

Alabama rates for HCPCS 99242

In this type of visit, a doctor requests the opinion or advice of another physician or qualified health professional about a specific problem with a patient's care. The consulting clinician evaluates the patient and sends a written report back to the requesting doctor. This particular level involves a relatively limited amount of history-taking, examination, and decision-making compared to higher levels of the same type of visit.

Rates data updated July 2026.

How much does Outpatient Specialist Consultation Visit cost?

$70.79

Typical physician fee. In Alabama, July 2026.

Insurers have agreed to pay about $70.79 for this service. Most negotiated rates run $53.70 to $105.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $100 · 10th to 90th $78 to $129Professionalmedian $71 · 10th to 90th $44 to $129
$10$20$50$100$200facility $100professional $71

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$67.61
Typical High
$128.82
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$72.44
Typical High
$154.88
BCBS
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$91.20
Typical High
$117.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$128.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$87.10
Typical High
$147.91
United
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$100.00
Typical High
$120.23
United
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$77.62
Typical High
$120.23

Where Alabama sits

The same service costs 1.7 times more in Minnesota than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Alabama· 47th of 51

$70.79

MN $115WV $66.07

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.