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West Virginia 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 $95 · 10th–90th $10–$1350%10%20%10th90th$95Professionalmedian $105 · 10th–90th $68–$1620%10%10th90th$105$5.0$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
$8.91 / $11.48 / $125.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $104.71 / $158.49
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $97.72 / $141.25
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $112.20 / $251.19
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
$87.10 / $125.89 / $446.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $117.49 / $181.97