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Florida 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 $68 · 10th–90th $50–$1050%20%10th90th$68Professionalmedian $87 · 10th–90th $50–$1450%10%20%10th90th$87$0.1$0.5$2.0$10.0$50.0$200.0

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
$50.12 / $67.61 / $104.71
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $89.13 / $147.91
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $75.86 / $144.54
AvMed
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $91.20 / $102.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $85.11 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $93.33 / $165.96
Florida Blue
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $79.43 / $104.71
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $64.57 / $109.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $70.79 / $93.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $79.43 / $138.04
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $57.54 / $77.62