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Comprehensive Specialist Consultation Visit

Colorado 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.

How much does Comprehensive Specialist Consultation Visit cost?

$186

Typical negotiated rate. In Colorado, July 2026.

Insurers have agreed to pay about $186 for this service. The price depends on where it is billed: about $182 from a physician practice, and about $251 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$182$151 to $224
FacilityA hospital or hospital-owned outpatient department$251$195 to $309

How much rates vary

Facilitymedian $251 · 10th to 90th $148 to $380Professionalmedian $182 · 10th to 90th $20 to $269
$20$50$100$200$500facility $251professional $182

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$14.79
Median
$81.28
Typical High
$371.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$181.97
Typical High
$251.19
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$223.87
Typical High
$338.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$251.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$269.15
Typical High
$407.38
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$257.04
Typical High
$389.05
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$302.00
Typical High
$645.65
Select Health
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$213.80
Typical High
$309.03
United
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$199.53
Typical High
$346.74
United
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$263.03
Typical High
$436.52

Where Colorado sits

The same service costs 1.5 times more in Minnesota than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Colorado· 44th of 51

$186

MN $275WV $178

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.