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Specialist Office Consultation

Nebraska rates for HCPCS 99243

This service covers an office visit where a specialist reviews a patient's specific health problem at the request of another treating clinician and provides an opinion or recommendation. It involves a detailed review of the person's history and a focused examination, along with medical decision-making of low complexity. A written report is typically sent back to the requesting clinician.

Rates data updated July 2026.

How much does Specialist Office Consultation cost?

$107

Typical negotiated rate. In Nebraska, July 2026.

Insurers have agreed to pay about $107 for this service. The price depends on where it is billed: about $107 from a physician practice, and about $138 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$107$87.10 to $135
FacilityA hospital or hospital-owned outpatient department$138$102 to $178

How much rates vary

Facilitymedian $138 · 10th to 90th $83 to $251Professionalmedian $107 · 10th to 90th $71 to $195
$1.0$10.0$100.0$1.0Kfacility $138professional $107

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$81.28
Typical High
$107.15
Aetna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$104.71
Typical High
$181.97
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$109.65
BCBS
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$281.84
BCBS
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$147.91
Typical High
$208.93
Cigna
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$165.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$128.82
Typical High
$234.42
Medica
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$134.90
Typical High
$213.80
Medica
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$204.17
Typical High
$741.31
Midlands
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$223.87
Typical High
$275.42
Midlands
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$223.87
Typical High
$275.42
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$295.12
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$104.71
Typical High
$218.78
United
Setting
Facility
Modifier
Global
Typical Low
$0.13
Median
$66.07
Typical High
$151.36
United
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$151.36
Typical High
$281.84

Where Nebraska sits

Rates are fairly even across states for this service. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Nebraska $107 · 29th of 51
MN $145WV $97.72

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.