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Florida rates for HCPCS 99245

Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.

Facilitymedian $166 · 10th–90th $135–$2340%20%40%10th90th$166Professionalmedian $204 · 10th–90th $145–$4170%20%10th90th$204$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $165.96 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $204.17 / $436.52
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $245.47 / $363.08
AvMed
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $229.09 / $251.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $275.42 / $275.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $251.19 / $426.58
Florida Blue
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $229.09
Florida Blue
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $199.53 / $269.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $181.97 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $173.78 / $229.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $208.93 / $363.08
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $158.49 / $213.80