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Comprehensive Specialist Consultation Visit

Connecticut 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 October 2026.

How much does Comprehensive Specialist Consultation Visit cost?

$229

Typical physician fee. In Connecticut, October 2026.

Insurers have agreed to pay about $229 for this service. Most negotiated rates run $174 to $269.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $200 · 10th to 90th $191 to $331Professionalmedian $229 · 10th to 90th $141 to $309
$200facility $200professional $229

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$199.53
Typical High
$331.13
Aetna
Setting
Professional
Modifier
None
Typical Low
$169.82
Median
$204.17
Typical High
$269.15
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$123.03
Median
$165.96
Typical High
$309.03
Cigna
Setting
Facility
Modifier
None
Typical Low
$281.84
Median
$281.84
Typical High
$281.84
Cigna
Setting
Professional
Modifier
None
Typical Low
$218.78
Median
$263.03
Typical High
$338.84
ConnectiCare
Setting
Professional
Modifier
None
Typical Low
$177.83
Median
$251.19
Typical High
$331.13
United
Setting
Professional
Modifier
None
Typical Low
$186.21
Median
$245.47
Typical High
$354.81
3 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$83.18
Median
$114.82
Typical High
$134.90
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$25.12
Median
$33.88
Typical High
$39.81
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$16.60
Median
$22.91
Typical High
$26.92

Where Connecticut sits

The same service costs 2.4 times more in Alaska than in Alabama. 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.

Connecticut· 16th of 51

$229

AK $380AL $158

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.