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Comprehensive Specialist Consultation Visit

Nationwide rates for HCPCS 99245

This is an in-depth office visit where a specialist evaluates a patient at the request of another provider, involving a thorough review of the patient's history, a detailed examination, and complex medical decision-making. It represents the most involved level of this type of consultation, typically used for patients with complicated or multiple medical problems. A written report is usually sent back to the referring provider afterward.

Rates data updated July 2026.

Facilitymedian $229 · 10th–90th $145$4170%20%40%10th90th$229Professionalmedian $200 · 10th–90th $141$4270%50%10th90th$200$0.0$0.2$2.0$20.0$200.0$2.0K$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
$117.49
Median
$186.21
Typical High
$323.59
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$194.98
Typical High
$338.84
BCBS
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$177.83
Typical High
$199.53
BCBS
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$181.97
Typical High
$354.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$251.19
Typical High
$281.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$251.19
Typical High
$416.87
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$186.21
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$229.09
Typical High
$478.63