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West 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.

Facilitymedian $59 · 10th–90th $7–$1070%10%10th90th$59Professionalmedian $76 · 10th–90th $45–$1350%5%10%10th90th$76$5.0$10.0$20.0$50.0$100.0$200.0

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
$6.03 / $8.32 / $125.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $72.44 / $134.90
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $61.66 / $89.13
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $74.13 / $162.18
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
$54.95 / $89.13 / $323.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $85.11 / $131.83