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Washington, DC 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 $129 · 10th–90th $129–$3240%50%90th$129Professionalmedian $83 · 10th–90th $46–$1380%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
$128.82 / $128.82 / $323.59
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $83.18 / $138.04
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $31.62 / $89.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $87.10 / $141.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $83.18 / $169.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $70.79
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $87.10 / $154.88