go back

New Mexico 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 $60–$1550%10%10th90th$95Professionalmedian $89 · 10th–90th $46–$1450%5%10%10th90th$89$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
$50.12 / $89.13 / $120.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $87.10 / $141.25
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $72.44 / $107.15
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
$61.66 / $95.50 / $141.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $74.13 / $117.49
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $100.00 / $165.96
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $104.71 / $177.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $109.65 / $120.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $104.71 / $162.18