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Comprehensive Specialist Consultation Visit

Indiana 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.

Facilitymedian $170 · 10th–90th $129$2630%20%10th90th$170Professionalmedian $186 · 10th–90th $138$2630%10%20%10th90th$186$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
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$162.18
Typical High
$257.04
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$181.97
Typical High
$245.47
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$204.17
Typical High
$269.15
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$199.53
Typical High
$309.03
CareSource
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$213.80
Typical High
$234.42
CareSource
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$239.88
Typical High
$309.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$223.87
Typical High
$302.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$234.42
Typical High
$371.54
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$147.91
Typical High
$218.78
United
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$218.78
Typical High
$338.84