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Specialist Office Consultation

New Hampshire 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?

$129

Typical negotiated rate. In New Hampshire, July 2026.

Insurers have agreed to pay about $129 for this service. The price depends on where it is billed: about $129 from a physician practice, and about $174 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 7 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$129$102 to $170
FacilityA hospital or hospital-owned outpatient department$174$132 to $302

How much rates vary

Facilitymedian $174 · 10th to 90th $115 to $389Professionalmedian $129 · 10th to 90th $83 to $240
$10.0$20.0$50.0$100.0$200.0$500.0$1.0Kfacility $174professional $129

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
$131.83
Median
$173.78
Typical High
$389.05
Aetna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$114.82
Typical High
$208.93
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$134.90
Typical High
$169.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$154.88
Typical High
$245.47
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$158.49
Typical High
$263.03
Optum
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$138.04
Typical High
$151.36
United
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$100.00
United
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$154.88
Typical High
$288.40
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$123.03
Typical High
$138.04

Where New Hampshire 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.

New Hampshire $129 · 4th 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.