go back

Washington, DC 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 $129 · 10th–90th $129–$4370%50%90th$129Professionalmedian $107 · 10th–90th $71–$1820%10%10th90th$107$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
$128.82 / $128.82 / $436.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $107.15 / $181.97
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $53.70 / $83.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $123.03 / $199.53
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $125.89 / $245.47
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $97.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $123.03 / $213.80