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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.

Facilitymedian $68 · 10th–90th $43–$1000%10%10th90th$68Professionalmedian $76 · 10th–90th $45–$1410%5%10%10th90th$76$5.0$10.0$20.0$50.0$100.0$200.0$500.0

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
$41.69 / $66.07 / $100.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $75.86 / $141.25
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $61.66 / $107.15
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $74.13 / $112.20
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $66.07 / $79.43
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $81.28 / $109.65
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $81.28 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $87.10 / $141.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $75.86 / $100.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $83.18 / $120.23