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Idaho 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 $107 · 10th–90th $62–$1740%10%20%10th90th$107Professionalmedian $91 · 10th–90th $48–$1510%10%20%10th90th$91$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $87.10 / $147.91
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $112.20 / $114.82
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $114.82 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $102.33 / $151.36
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $107.15 / $173.78
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $104.71 / $165.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $138.04
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $112.20 / $114.82
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $81.28 / $141.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $100.00 / $151.36