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New York rates for HCPCS 99244

Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.

Facilitymedian $155 · 10th–90th $89–$2510%20%10th90th$155Professionalmedian $162 · 10th–90th $107–$3980%10%20%10th90th$162$0.0$0.2$2.0$20.0$200.0

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
$100.00 / $154.88 / $251.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $165.96 / $426.58
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $158.49 / $165.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $123.03 / $275.42
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $251.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $218.78 / $416.87
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.10 / $67.61 / $107.15
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $288.40
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $165.96 / $354.81
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.03 / $0.05
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $186.21 / $251.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $100.00 / $194.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $128.82 / $338.84
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $128.82 / $331.13
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $165.96 / $338.84