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Detailed Specialist Consultation

North Carolina 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?

$200

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $200 for this service. The price depends on where it is billed: about $200 from a physician practice, and about $195 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 8 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$200$151 to $295
FacilityA hospital or hospital-owned outpatient department$195$162 to $251

How much rates vary

Facilitymedian $195 · 10th to 90th $145 to $347Professionalmedian $200 · 10th to 90th $120 to $407
$20$50$100$200$500facility $195professional $200

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
$147.91
Median
$173.78
Typical High
$446.68
Aetna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$162.18
Typical High
$446.68
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$213.80
Typical High
$323.59
BCBS
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$288.40
Typical High
$389.05
Cigna
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$186.21
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$204.17
Typical High
$354.81
Medcost
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$208.93
Typical High
$331.13
Medcost
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$199.53
Typical High
$309.03
Medcost
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$457.09
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$177.83
Typical High
$229.09
United
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$141.25
Typical High
$204.17
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$177.83
Typical High
$309.03
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$933.25
Typical High
$933.25
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$1,122.02
Median
$1,122.02
Typical High
$1,122.02

Where North Carolina 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.

North Carolina· 2nd of 51

$200

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.