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Outpatient Specialist Consultation Visit

Nevada 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?

$74.13

Typical negotiated rate. In Nevada, July 2026.

Insurers have agreed to pay about $74.13 for this service. The price depends on where it is billed: about $74.13 from a physician practice, and about $67.61 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$74.13$56.23 to $115
FacilityA hospital or hospital-owned outpatient department$67.61$67.61 to $74.13

How much rates vary

Facilitymedian $68 · 10th to 90th $42 to $123Professionalmedian $74 · 10th to 90th $46 to $141
$10$20$50$100$200facility $68professional $74

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$6.92
Median
$107.15
Typical High
$144.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$72.44
Typical High
$141.25
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$74.13
Typical High
$74.13
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$61.66
Typical High
$120.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$91.20
Typical High
$138.04
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$0.85
Median
$0.85
Typical High
$95.50
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$0.85
Median
$0.85
Typical High
$0.85
Select Health
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$67.61
Typical High
$74.13
Select Health
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$57.54
Typical High
$380.19
United
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$79.43
Typical High
$186.21
United
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$89.13
Typical High
$144.54

Where Nevada 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.

Nevada· 39th of 51

$74.13

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.