go back

New Hampshire 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 $214 · 10th–90th $83–$2820%20%10th90th$214Professionalmedian $89 · 10th–90th $48–$1480%5%10%10th90th$89$5.0$20.0$100.0$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
$95.50 / $213.80 / $281.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $83.18 / $138.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $104.71 / $177.83
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $104.71 / $173.78
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $87.10 / $107.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $107.15 / $194.98
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $81.28 / $91.20