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Idaho 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 $263 · 10th–90th $178–$4170%20%10th90th$263Professionalmedian $204 · 10th–90th $145–$4270%20%10th90th$204$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $199.53 / $407.38
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $316.23 / $316.23
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $363.08 / $426.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $281.84 / $407.38
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $263.03 / $416.87
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $269.15 / $446.68
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $389.05
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $316.23 / $316.23
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $251.19 / $398.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $269.15 / $380.19