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Comprehensive Specialist Consultation Visit

Washington, DC 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?

$178

Typical physician fee. In Washington, DC, October 2026.

Insurers have agreed to pay about $178 for this service. Most negotiated rates run $151 to $204.

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 $178 · 10th to 90th $135 to $240Professionalmedian $178 · 10th to 90th $115 to $257
$100$200$500facility $178professional $178

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
$134.90
Median
$177.83
Typical High
$239.88
Aetna
Setting
Professional
Modifier
None
Typical Low
$151.36
Median
$181.97
Typical High
$239.88
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$87.10
Median
$100.00
Typical High
$120.23
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$26.92
Median
$30.20
Typical High
$35.48
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$17.78
Median
$19.95
Typical High
$23.99
CareFirst
Setting
Professional
Modifier
None
Typical Low
$109.65
Median
$114.82
Typical High
$138.04
Cigna
Setting
Professional
Modifier
None
Typical Low
$151.36
Median
$181.97
Typical High
$295.12
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$194.98
Median
$229.09
Typical High
$436.52
United
Setting
Professional
Modifier
None
Typical Low
$147.91
Median
$204.17
Typical High
$389.05

Where Washington, DC 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.

Washington, DC· 44th of 51

$178

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.