go back

Nebraska 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 $95 · 10th–90th $52–$1550%10%20%10th90th$95Professionalmedian $79 · 10th–90th $45–$1380%10%10th90th$79$0.1$0.5$2.0$10.0$50.0$200.0

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
$52.48 / $114.82 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $77.62 / $138.04
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $72.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $93.33 / $138.04
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $85.11 / $123.03
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $89.13 / $154.88
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $151.36 / $537.03
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $147.91 / $181.97
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $147.91 / $181.97
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $74.13 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.09 / $30.20 / $100.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $102.33 / $177.83