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Specialist Office Consultation

Nevada 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?

$105

Typical negotiated rate. In Nevada, July 2026.

Insurers have agreed to pay about $105 for this service. The price depends on where it is billed: about $105 from a physician practice, and about $100 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$105$83.18 to $123
FacilityA hospital or hospital-owned outpatient department$100$100 to $112

How much rates vary

Facilitymedian $100 · 10th to 90th $65 to $132Professionalmedian $105 · 10th to 90th $68 to $158
$1.0$5.0$20.0$100.0$500.0facility $100professional $105

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$9.77
Median
$107.15
Typical High
$144.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$102.33
Typical High
$154.88
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$112.20
Typical High
$257.04
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$89.13
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$125.89
Typical High
$186.21
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$1.10
Median
$1.10
Typical High
$125.89
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$1.10
Median
$1.10
Typical High
$1.10
Select Health
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$100.00
Typical High
$112.20
Select Health
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$91.20
Typical High
$467.74
United
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$100.00
Typical High
$213.80
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$123.03
Typical High
$199.53

Where Nevada 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.

Nevada $105 · 37th 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.