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Comprehensive Specialist Consultation Visit

Idaho 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?

$209

Typical negotiated rate. In Idaho, July 2026.

Insurers have agreed to pay about $209 for this service. The price depends on where it is billed: about $209 from a physician practice, and about $263 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$209$178 to $269
FacilityA hospital or hospital-owned outpatient department$263$214 to $331

How much rates vary

Facilitymedian $263 · 10th to 90th $178 to $417Professionalmedian $209 · 10th to 90th $148 to $417
$20$50$100$200$500facility $263professional $209

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
Professional
Modifier
Global
Typical Low
$144.54
Median
$204.17
Typical High
$354.81
BCBS
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$316.23
Typical High
$331.13
BCBS
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$363.08
Typical High
$426.58
Cigna
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$275.42
Typical High
$407.38
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$263.03
Typical High
$416.87
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$346.74
Typical High
$467.74
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$389.05
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$316.23
Typical High
$331.13
Select Health
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$204.17
Typical High
$204.17
Select Health
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$281.84
Typical High
$758.58
United
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$275.42
Typical High
$380.19

Where Idaho 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.

Idaho· 12th of 51

$209

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.