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Georgia 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 $229 · 10th–90th $155–$3160%10%10th90th$229Professionalmedian $204 · 10th–90th $145–$3890%10%10th90th$204$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $194.98 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $199.53 / $389.05
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $218.78 / $380.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $223.87 / $398.11
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $245.47 / $316.23
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $251.19 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $257.04 / $398.11
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $245.47 / $467.74
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $331.13 / $549.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $229.09 / $281.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $234.42 / $371.54