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Indiana 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
$40.38 / $53.84 / $72.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.21 / $64.41 / $123.60
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.90 / $69.34 / $78.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.40 / $72.20 / $101.14
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.09 / $61.31 / $74.20
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.68 / $82.42 / $99.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.68 / $73.68 / $108.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.91 / $86.50 / $127.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.33 / $92.70 / $127.83