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Comprehensive Specialist Consultation Visit

Arizona 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 $219 · 10th–90th $166$3720%20%10th90th$219Professionalmedian $195 · 10th–90th $138$5620%20%10th90th$195$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
$134.90
Median
$165.96
Typical High
$354.81
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$194.98
Typical High
$575.44
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$218.78
Typical High
$316.23
BCBS
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$275.42
Typical High
$1,348.96
BCBS
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$190.55
Typical High
$295.12
Cigna
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$251.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$234.42
Typical High
$407.38
Medica
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$213.80
Typical High
$346.74
Medica
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$295.12
Typical High
$1,348.96
United
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$138.04
Typical High
$229.09
United
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$218.78
Typical High
$371.54