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Detailed Specialist Consultation

Pennsylvania 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.

Facilitymedian $18 · 10th–90th $8$3470%10%20%10th90th$18Professionalmedian $158 · 10th–90th $98$3980%20%10th90th$158$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
Setting
Facility
Modifier
Global
Typical Low
$7.94
Median
$17.78
Typical High
$346.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$154.88
Typical High
$407.38
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$158.49
Typical High
$218.78
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$8,511.38
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$302.00
Typical High
$380.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$186.21
Cigna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$186.21
Typical High
$288.40
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$302.00
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$112.20
Typical High
$316.23
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$251.19
Typical High
$446.68
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$169.82
Independence Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$239.88
Johns Hopkins Employer Health Plan
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$269.15
Johns Hopkins Employer Health Plan
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$223.87
Typical High
$269.15
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$9.55
Median
$17.78
Typical High
$346.74
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$162.18
Typical High
$331.13
Optum
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$177.83
Typical High
$229.09
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$776.25
Median
$776.25
Typical High
$776.25
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$162.18
Typical High
$229.09
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$380.19
Typical High
$562.34
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$169.82
Typical High
$199.53
United
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$213.80
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$181.97
Typical High
$316.23