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Minnesota 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 $126 · 10th–90th $81–$2630%10%10th90th$126Professionalmedian $138 · 10th–90th $78–$3160%5%10th90th$138$5.0$20.0$100.0$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
$72.44 / $93.33 / $125.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $107.15 / $199.53
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $162.18 / $1,348.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $234.42 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $123.03 / $218.78
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $199.53 / $257.04
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $138.04 / $251.19
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $275.42 / $588.84
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
$100.00 / $194.98 / $302.00