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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.

Facilitymedian $794 · 10th–90th $129$7940%50%10th$794Professionalmedian $186 · 10th–90th $138$2570%10%10th90th$186$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
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