go back

Outpatient Specialist Consultation Visit

Oklahoma 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?

$81.28

Typical negotiated rate. In Oklahoma, July 2026.

Insurers have agreed to pay about $81.28 for this service. The price depends on where it is billed: about $79.43 from a physician practice, and about $89.13 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 6 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$79.43$58.88 to $112
FacilityA hospital or hospital-owned outpatient department$89.13$67.61 to $138

How much rates vary

Facilitymedian $89 · 10th to 90th $62 to $155Professionalmedian $79 · 10th to 90th $45 to $138
$10$20$50$100$200facility $89professional $79

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
$61.66
Median
$61.66
Typical High
$79.43
Aetna
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$79.43
Typical High
$138.04
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$72.44
Typical High
$154.88
BCBS
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$87.10
Typical High
$125.89
Medica
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$95.50
Typical High
$162.18
Medica
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$104.71
Typical High
$537.03
United
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$91.20
Typical High
$128.82
United
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$83.18
Typical High
$123.03

Where Oklahoma 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.

Oklahoma· 30th of 51

$81.28

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.