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Nebraska 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 $145 · 10th–90th $83–$2510%10%20%10th90th$145Professionalmedian $107 · 10th–90th $71–$1820%20%10th90th$107$0.2$1.0$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
$79.43 / $181.97 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $107.15 / $177.83
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $109.65
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $147.91 / $208.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $165.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $114.82 / $165.96
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $134.90 / $213.80
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $204.17 / $741.31
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $223.87 / $275.42
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $223.87 / $275.42
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $295.12
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $114.82 / $257.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.13 / $66.07 / $151.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $144.54 / $257.04