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Missouri 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 $98 · 10th–90th $63–$1480%10%10th90th$98Professionalmedian $83 · 10th–90th $47–$1480%5%10%10th90th$83$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
$72.44 / $100.00 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $83.18 / $151.36
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $66.07 / $100.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $66.07 / $114.82
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $74.13 / $109.65
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $91.20 / $144.54
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $93.33 / $169.82
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $112.20 / $537.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $60.26 / $100.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $83.18 / $128.82