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Outpatient Specialist Consultation Visit

Kansas 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 negotiated rate. In Kansas, July 2026.

Insurers have agreed to pay about $87.10 for this service. The price depends on where it is billed: about $87.10 from a physician practice, and about $93.33 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$87.10$66.07 to $112
FacilityA hospital or hospital-owned outpatient department$93.33$74.13 to $120

How much rates vary

Facilitymedian $93 · 10th to 90th $62 to $178Professionalmedian $87 · 10th to 90th $52 to $126
$10$20$50$100$200facility $93professional $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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$81.28
Typical High
$107.15
Aetna
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$77.62
Typical High
$128.82
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$67.61
Typical High
$100.00
BCBS
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$87.10
Typical High
$117.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$93.33
Typical High
$144.54
Medica
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$93.33
Typical High
$181.97
Medica
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$123.03
Typical High
$537.03
United
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$100.00
Typical High
$141.25
United
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$91.20
Typical High
$134.90

Where Kansas 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.

Kansas· 19th 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.