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Comprehensive Specialist Consultation Visit

Florida 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 $166 · 10th–90th $135$2340%20%40%10th90th$166Professionalmedian $200 · 10th–90th $141$3550%20%10th90th$200$0.2$1.0$5.0$20.0$100.0$500.0

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
$134.90
Median
$165.96
Typical High
$234.42
Aetna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$194.98
Typical High
$354.81
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$218.78
Typical High
$363.08
AvMed
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$229.09
Typical High
$251.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$251.19
Typical High
$251.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$251.19
Typical High
$436.52
Florida Blue
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$229.09
Typical High
$229.09
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$204.17
Typical High
$269.15
Molina
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$186.21
Typical High
$309.03
United
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$169.82
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$213.80
Typical High
$389.05
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$158.49
Typical High
$213.80