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Maine 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
$63.10 / $81.28 / $120.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $81.28 / $134.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $64.57 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $85.11 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $95.50 / $158.49
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $112.20 / $186.21
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.10 / $81.28 / $120.23
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $97.72 / $162.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $100.00 / $162.18