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Specialist Office Consultation

Alabama rates for HCPCS 99243

This service covers an office visit where a specialist reviews a patient's specific health problem at the request of another treating clinician and provides an opinion or recommendation. It involves a detailed review of the person's history and a focused examination, along with medical decision-making of low complexity. A written report is typically sent back to the requesting clinician.

Rates data updated July 2026.

How much does Specialist Office Consultation cost?

$100

Typical physician fee. In Alabama, July 2026.

Insurers have agreed to pay about $100 for this service. Most negotiated rates run $81.28 to $120.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $120 · 10th to 90th $102 to $174Professionalmedian $100 · 10th to 90th $66 to $141
$10.0$20.0$50.0$100.0$200.0$500.0facility $120professional $100

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$97.72
Typical High
$141.25
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$112.20
Typical High
$204.17
BCBS
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$125.89
Typical High
$158.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$120.23
Typical High
$204.17
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$120.23
Typical High
$151.36
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$107.15
Typical High
$173.78

Where Alabama sits

Rates are fairly even across states for this service. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Alabama $100 · 47th of 51
MN $145WV $97.72

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.