go back

Indiana 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 $191 · 10th–90th $138–$2750%10%20%10th90th$191Professionalmedian $195 · 10th–90th $138–$3240%10%10th90th$195$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $169.82 / $275.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $190.55 / $316.23
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $269.15
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $199.53 / $309.03
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $213.80 / $263.03
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $229.09 / $309.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $223.87 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $234.42 / $371.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $173.78 / $281.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $213.80 / $323.59