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Louisiana 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 $85 · 10th–90th $66–$1230%20%10th90th$85Professionalmedian $83 · 10th–90th $46–$1380%5%10%10th90th$83$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
$66.07 / $85.11 / $104.71
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $85.11 / $141.25
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $75.86
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $63.10 / $91.20
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $93.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $83.18 / $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
$56.23 / $79.43 / $120.23