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Comprehensive Specialist Consultation Visit

Georgia 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?

$200

Typical negotiated rate. In Georgia, July 2026.

Insurers have agreed to pay about $200 for this service. The price depends on where it is billed: about $200 from a physician practice, and about $182 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$200$170 to $240
FacilityA hospital or hospital-owned outpatient department$182$166 to $240

How much rates vary

Facilitymedian $182 · 10th to 90th $155 to $316Professionalmedian $200 · 10th to 90th $148 to $363
$20$50$100$200$500facility $182professional $200

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
$154.88
Median
$181.97
Typical High
$316.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$194.98
Typical High
$354.81
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$234.42
Typical High
$776.25
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$223.87
Typical High
$398.11
CareSource
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$218.78
Typical High
$245.47
CareSource
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$251.19
Typical High
$309.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$257.04
Typical High
$398.11
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$245.47
Typical High
$467.74
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$239.88
Typical High
$457.09
United
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$169.82
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$234.42
Typical High
$389.05

Where Georgia 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.

Georgia· 20th of 51

$200

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.