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Kansas 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 $87–$1860%10%10th90th$129Professionalmedian $110 · 10th–90th $72–$1510%10%10th90th$110$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
$87.10 / $117.49 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $107.15 / $151.36
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $104.71 / $138.04
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $109.65 / $138.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $128.82 / $204.17
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $134.90 / $208.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $165.96 / $741.31
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
$93.33 / $125.89 / $177.83