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Georgia 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.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.59 / $107.58 / $134.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.95 / $96.56 / $140.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.68 / $85.68 / $85.68
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.41 / $80.86 / $136.50
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.17 / $72.86 / $99.10
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.54 / $85.85 / $111.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.68 / $73.68 / $73.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.45 / $101.69 / $163.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.93 / $89.10 / $171.89
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.81 / $132.38 / $220.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.81 / $107.41 / $165.35