go back

Outpatient Specialist Consultation Visit

Rhode Island 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?

$93.33

Typical physician fee. In Rhode Island, July 2026.

Insurers have agreed to pay about $93.33 for this service. Most negotiated rates run $69.18 to $107.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $102 · 10th to 90th $78 to $102Professionalmedian $93 · 10th to 90th $54 to $126
$50$100facility $102professional $93

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
$77.62
Median
$77.62
Typical High
$102.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$93.33
Typical High
$125.89
BCBS
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$128.82
Typical High
$257.04
BCBS
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$72.44
Typical High
$120.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$95.50
Typical High
$147.91
United
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$85.11
Typical High
$147.91

Where Rhode Island 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.

Rhode Island· 12th of 51

$93.33

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.