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Oregon 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 $174 · 10th–90th $95–$2400%20%10th90th$174Professionalmedian $120 · 10th–90th $74–$2820%10%20%10th90th$120$1.0$10.0$100.0$1.0K$10.0K

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
$120.23 / $204.17 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $114.82 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $173.78 / $275.42
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $208.93 / $269.15
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $141.25 / $239.88
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $186.21 / $275.42
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $223.87 / $234.42
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $141.25 / $239.88
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $208.93 / $281.84
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $251.19 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $100.00 / $151.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $181.97 / $288.40