go back

Delaware 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 $6 · 10th–90th $5–$980%20%10th90th$6Professionalmedian $107 · 10th–90th $65–$1910%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
$4.79 / $6.17 / $97.72
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $107.15 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $123.03 / $204.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $114.82 / $186.21