go back

Missouri 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 $151 · 10th–90th $95–$2140%10%20%10th90th$151Professionalmedian $110 · 10th–90th $72–$2190%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
$120.23 / $154.88 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $109.65 / $218.78
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $107.15 / $138.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $95.50 / $162.18
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $112.20 / $158.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $125.89 / $199.53
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $134.90 / $257.04
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $154.88 / $741.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $66.07 / $151.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $117.49 / $186.21