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Virginia 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.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.15 / $65.12 / $468.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.90 / $73.79 / $129.41
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $52.15 / $100.00
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.61 / $31.61 / $61.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.68 / $73.68 / $73.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.60 / $94.46 / $168.30
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.36 / $85.78 / $151.47
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.20 / $98.83 / $147.71
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.87 / $122.00 / $165.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.23 / $89.88 / $145.66
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.81 / $117.19 / $187.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.78 / $100.42 / $164.78