go back

Detailed Specialist Consultation

New Jersey 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?

$155

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $155 for this service. The price depends on where it is billed: about $155 from a physician practice, and about $135 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 6 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 $191
FacilityA hospital or hospital-owned outpatient department$135$102 to $166

How much rates vary

Facilitymedian $135 · 10th to 90th $98 to $214Professionalmedian $155 · 10th to 90th $102 to $275
$10$20$50$100$200$500facility $135professional $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
$97.72
Median
$134.90
Typical High
$213.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$147.91
Typical High
$234.42
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$158.49
Typical High
$208.93
Cigna
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$173.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$208.93
Typical High
$331.13
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$104.71
Typical High
$288.40
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$204.17
Typical High
$331.13
United
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$147.91
Typical High
$223.87
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$165.96
Typical High
$316.23

Where New Jersey 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.

New Jersey· 38th of 51

$155

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.