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Oregon 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 $123 · 10th–90th $66–$1780%20%10th90th$123Professionalmedian $102 · 10th–90th $51–$1950%10%20%10th90th$102$1.0$10.0$100.0$1.0K$10.0K

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
$87.10 / $128.82 / $177.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $91.20 / $199.53
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
$66.07 / $114.82 / $194.98
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $134.90 / $181.97
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $104.71 / $190.55
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $128.82 / $190.55
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $147.91 / $169.82
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $104.71 / $199.53
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $138.04 / $190.55
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $181.97 / $316.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $79.43 / $100.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $131.83 / $204.17