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Arizona rates for HCPCS 99243

Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.

Facilitymedian $115 · 10th–90th $81–$2140%10%10th90th$115Professionalmedian $112 · 10th–90th $71–$3020%10%10th90th$112$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 / $102.33 / $257.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $112.20 / $316.23
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $109.65 / $151.36
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $138.04 / $676.08
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $97.72 / $154.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $125.89 / $218.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $114.82 / $181.97
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $162.18 / $741.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $85.11 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $114.82 / $194.98