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Indiana 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 $100 · 10th–90th $68–$1480%10%10th90th$100Professionalmedian $107 · 10th–90th $71–$1780%10%10th90th$107$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
$67.61 / $87.10 / $147.91
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $104.71 / $177.83
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $109.65 / $162.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $107.15 / $165.96
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $104.71 / $128.82
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $123.03 / $165.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $112.20 / $173.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $125.89 / $199.53
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $100.00 / $151.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $114.82 / $177.83