go back

Connecticut 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 $195 · 10th–90th $60–$3890%10%10th90th$195Professionalmedian $200 · 10th–90th $138–$3890%10%10th90th$200$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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
$60.26 / $194.98 / $389.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $194.98 / $380.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $208.93 / $371.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $269.15 / $416.87
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $288.40 / $416.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $173.78 / $204.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $251.19 / $416.87