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Nevada 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 $100 · 10th–90th $9–$2140%20%10th90th$100Professionalmedian $107 · 10th–90th $68–$1740%10%10th90th$107$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.91 / $107.15 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $107.15 / $169.82
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $112.20 / $363.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $93.33 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $125.89 / $186.21
Hometown Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.10 / $1.10 / $125.89
Hometown Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.10 / $1.10 / $1.10
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $112.20 / $165.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $100.00 / $213.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $123.03 / $199.53