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Rhode Island 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 $102 · 10th–90th $78–$1020%20%40%10th$102Professionalmedian $79 · 10th–90th $45–$1320%10%10th90th$79$5.0$10.0$20.0$50.0$100.0$200.0$500.0

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
$77.62 / $77.62 / $102.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $77.62 / $128.82
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $128.82 / $257.04
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $72.44 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $97.72 / $147.91
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $91.20 / $162.18