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Arizona 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 $76 · 10th–90th $52–$1480%10%10th90th$76Professionalmedian $87 · 10th–90th $47–$1950%5%10th90th$87$5.0$20.0$100.0$500.0$2.0K

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
$48.98 / $64.57 / $87.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $87.10 / $199.53
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $61.66 / $75.86
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $100.00 / $489.78
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $66.07 / $107.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $97.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $89.13 / $151.36
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $77.62 / $144.54
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $112.20 / $537.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $61.66 / $95.50
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $83.18 / $134.90