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Comprehensive Specialist Consultation Visit

Delaware 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?

$178

Typical physician fee. In Delaware, July 2026.

Insurers have agreed to pay about $178 for this service. Most negotiated rates run $155 to $214.

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 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $186 · 10th to 90th $10 to $1,047Professionalmedian $178 · 10th to 90th $123 to $245
$10$20$50$100$200$500$1Kfacility $186professional $178

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
$9.55
Median
$186.21
Typical High
$1,047.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$177.83
Typical High
$239.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$229.09
Typical High
$363.08
United
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$213.80
Typical High
$346.74

Where Delaware 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.

Delaware· 50th of 51

$178

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.