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Detailed Specialist Consultation

Illinois rates for HCPCS 99244

This office visit covers a thorough consultation with a specialist, called in by another doctor to evaluate a specific problem and give an opinion or recommendation back to the referring provider. It involves a detailed history, a comprehensive examination, and decision-making of moderate complexity. A written report is typically sent back to the doctor who requested the opinion.

Rates data updated July 2026.

How much does Detailed Specialist Consultation cost?

$158

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $158 for this service. The price depends on where it is billed: about $155 from a physician practice, and about $240 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$155$129 to $195
FacilityA hospital or hospital-owned outpatient department$240$141 to $282

How much rates vary

Facilitymedian $240 · 10th to 90th $117 to $324Professionalmedian $155 · 10th to 90th $110 to $275
$20$50$100$200$500facility $240professional $155

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$239.88
Typical High
$323.59
Aetna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$151.36
Typical High
$239.88
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$158.49
Typical High
$263.03
BCBS
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$416.87
Typical High
$602.56
Cigna
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$218.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$199.53
Typical High
$309.03
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$208.93
Typical High
$616.60
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$165.96
Typical High
$213.80
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$70.79
Typical High
$229.09
United
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$134.90
Typical High
$162.18
United
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$229.09
Typical High
$346.74

Where Illinois sits

The same service costs 1.5 times more in Minnesota than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Illinois· 20th of 51

$158

MN $219WV $141

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.