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Arizona rates for HCPCS 99245

Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.

Facilitymedian $214 · 10th–90th $166–$3630%20%10th90th$214Professionalmedian $204 · 10th–90th $141–$6610%20%10th90th$204$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $194.98 / $245.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $204.17 / $676.08
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $213.80 / $245.47
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $275.42 / $1,348.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $190.55 / $295.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $275.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $234.42 / $407.38
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $213.80 / $346.74
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $295.12 / $1,348.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $162.18 / $229.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $213.80 / $363.08