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Specialist Office Consultation

Florida 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 Florida, 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 $93.33 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 8 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$89.13 to $132
FacilityA hospital or hospital-owned outpatient department$93.33$72.44 to $105

How much rates vary

Facilitymedian $93 · 10th to 90th $71 to $126Professionalmedian $107 · 10th to 90th $72 to $191
$1.0$10.0$100.0facility $93professional $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
$70.79
Median
$93.33
Typical High
$125.89
Aetna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$107.15
Typical High
$186.21
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$109.65
Typical High
$194.98
AvMed
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$125.89
Typical High
$138.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$123.03
Typical High
$123.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$131.83
Typical High
$234.42
Florida Blue
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$109.65
Typical High
$147.91
Molina
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$95.50
Typical High
$162.18
United
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$120.23
Typical High
$169.82
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$117.49
Typical High
$223.87
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$87.10
Typical High
$114.82

Where Florida 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.

Florida $107 · 27th 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.