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Specialist Office Consultation

Arizona 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?

$107

Typical negotiated rate. In Arizona, July 2026.

Insurers have agreed to pay about $107 for this service. The price depends on where it is billed: about $107 from a physician practice, and about $115 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$107$85.11 to $135
FacilityA hospital or hospital-owned outpatient department$115$93.33 to $148

How much rates vary

Facilitymedian $115 · 10th to 90th $81 to $214Professionalmedian $107 · 10th to 90th $69 to $234
$5.0$10.0$20.0$50.0$100.0$200.0$500.0facility $115professional $107

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$104.71
Typical High
$288.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$104.71
Typical High
$218.78
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$109.65
Typical High
$162.18
BCBS
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$138.04
Typical High
$676.08
BCBS
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$97.72
Typical High
$154.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$123.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$125.89
Typical High
$213.80
Medica
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$114.82
Typical High
$181.97
Medica
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$162.18
Typical High
$741.31
United
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$102.33
Typical High
$131.83
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$117.49
Typical High
$204.17

Where Arizona 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.

Arizona $107 · 35th 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.