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Nevada 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 $79 · 10th–90th $6–$1860%5%10%10th90th$79Professionalmedian $83 · 10th–90th $45–$1410%5%10%10th90th$83$1.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.03 / $107.15 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $83.18 / $141.25
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $66.07 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $91.20 / $138.04
Hometown Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.85 / $0.85 / $95.50
Hometown Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.85 / $0.85 / $0.85
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $74.13 / $120.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $79.43 / $186.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $89.13 / $144.54