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Colorado 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 $81 · 10th–90th $15–$3720%10%20%10th90th$81Professionalmedian $195 · 10th–90th $129–$3800%20%10th90th$195$0.2$1.0$5.0$20.0$100.0$500.0

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
$14.79 / $81.28 / $371.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $194.98 / $380.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $223.87 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $269.15 / $398.11
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $302.00 / $645.65
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $213.80 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.23 / $281.84 / $346.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $269.15 / $416.87