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Outpatient Specialist Consultation Visit

New Hampshire rates for HCPCS 99242

In this type of visit, a doctor requests the opinion or advice of another physician or qualified health professional about a specific problem with a patient's care. The consulting clinician evaluates the patient and sends a written report back to the requesting doctor. This particular level involves a relatively limited amount of history-taking, examination, and decision-making compared to higher levels of the same type of visit.

Rates data updated July 2026.

How much does Outpatient Specialist Consultation Visit cost?

$93.33

Typical negotiated rate. In New Hampshire, July 2026.

Insurers have agreed to pay about $93.33 for this service. The price depends on where it is billed: about $93.33 from a physician practice, and about $126 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$93.33$67.61 to $123
FacilityA hospital or hospital-owned outpatient department$126$95.50 to $214

How much rates vary

Facilitymedian $126 · 10th to 90th $83 to $282Professionalmedian $93 · 10th to 90th $55 to $151
$10$20$50$100$200facility $126professional $93

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$125.89
Typical High
$281.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$85.11
Typical High
$144.54
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$85.11
Typical High
$107.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$104.71
Typical High
$177.83
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$104.71
Typical High
$173.78
Optum
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$87.10
Typical High
$107.15
United
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$79.43
United
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$104.71
Typical High
$194.98
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$81.28
Typical High
$91.20

Where New Hampshire sits

The same service costs 1.7 times more in Minnesota than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Hampshire· 13th of 51

$93.33

MN $115WV $66.07

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.