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Comprehensive Specialist Consultation Visit

Hawaii 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 October 2026.

How much does Comprehensive Specialist Consultation Visit cost?

$275

Typical physician fee. In Hawaii, October 2026.

Insurers have agreed to pay about $275 for this service. Most negotiated rates run $245 to $288.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $275 · 10th to 90th $204 to $380
$200professional $275

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$147.91
Median
$199.53
Typical High
$275.42
Cigna
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$251.19
Typical High
$380.19
HMSA
Setting
Professional
Modifier
None
Typical Low
$229.09
Median
$269.15
Typical High
$295.12
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$109.65
Median
$177.83
Typical High
$676.08
United
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$380.19
Typical High
$380.19
University Health Alliance
Setting
Professional
Modifier
None
Typical Low
$234.42
Median
$281.84
Typical High
$281.84
3 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$72.44
Median
$93.33
Typical High
$120.23
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$21.88
Median
$27.54
Typical High
$35.48
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$14.79
Median
$18.62
Typical High
$23.99

Where Hawaii sits

The same service costs 2.4 times more in Alaska than in Alabama. 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.

Hawaii· 6th of 51

$275

AK $380AL $158

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.