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Minnesota 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 $83 · 10th–90th $51–$1700%5%10%10th90th$83Professionalmedian $112 · 10th–90th $54–$2090%5%10%10th90th$112$5.0$20.0$100.0$500.0$2.0K

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
$44.67 / $61.66 / $83.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $83.18 / $151.36
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $102.33 / $954.99
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $151.36 / $208.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $89.13 / $151.36
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $173.78 / $186.21
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $97.72 / $165.96
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $181.97 / $537.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $79.43 / $100.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $128.82 / $213.80