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Rhode Island 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 $115 · 10th–90th $110–$1380%20%10th90th$115Professionalmedian $105 · 10th–90th $68–$1480%10%10th90th$105$10.0$20.0$50.0$100.0$200.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $114.82 / $138.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $104.71 / $147.91
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $194.98 / $354.81
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $102.33 / $165.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $134.90 / $218.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $128.82 / $234.42