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Outpatient Specialist Consultation Visit

Hawaii 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?

$87.10

Typical physician fee. In Hawaii, July 2026.

Insurers have agreed to pay about $87.10 for this service. Most negotiated rates run $63.10 to $117.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $141 · 10th to 90th $141 to $141Professionalmedian $87 · 10th to 90th $51 to $145
$50$100$200facility $141professional $87

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
$51.29
Median
$83.18
Typical High
$147.91
Cigna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$93.33
Typical High
$144.54
HMSA
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$112.20
Typical High
$131.83
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$177.83
Typical High
$676.08
United
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$141.25
United
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$83.18
Typical High
$128.82
University Health Alliance
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$97.72
Typical High
$114.82

Where Hawaii 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.

Hawaii· 17th of 51

$87.10

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.