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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 July 2026.

How much does Comprehensive Specialist Consultation Visit cost?

$186

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

Insurers have agreed to pay about $186 for this service. Most negotiated rates run $158 to $219.

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 $794 · 10th to 90th $129 to $794Professionalmedian $186 · 10th to 90th $138 to $257
$20$50$100$200$500facility $794professional $186

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
$128.82
Median
$794.33
Typical High
$794.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$186.21
Typical High
$245.47
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$114.82
Typical High
$446.68
Cigna
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$234.42
Typical High
$371.54
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$229.09
Typical High
$436.52
United
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$173.78
United
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$234.42
Typical High
$436.52

Where Washington, DC 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.

Washington, DC· 45th 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.