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Outpatient Specialist Consultation Visit

Oregon 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?

$107

Typical negotiated rate. In Oregon, July 2026.

Insurers have agreed to pay about $107 for this service. The price depends on where it is billed: about $105 from a physician practice, and about $123 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 8 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$105$69.18 to $141
FacilityA hospital or hospital-owned outpatient department$123$87.10 to $151

How much rates vary

Facilitymedian $123 · 10th to 90th $66 to $178Professionalmedian $105 · 10th to 90th $52 to $191
$5$10$20$50$100$200facility $123professional $105

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
$66.07
Median
$128.82
Typical High
$177.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$93.33
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$114.82
Typical High
$194.98
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$134.90
Typical High
$181.97
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$102.33
Typical High
$199.53
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$134.90
Typical High
$186.21
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$147.91
Typical High
$169.82
Providence
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$104.71
Typical High
$199.53
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$138.04
Typical High
$190.55
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$251.19
Typical High
$446.68
United
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$79.43
Typical High
$100.00
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$131.83
Typical High
$208.93

Where Oregon 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.

Oregon· 3rd of 51

$107

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.