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Comprehensive Specialist Consultation Visit

Kentucky 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 $174 · 10th–90th $135$2510%10%20%10th90th$174Professionalmedian $186 · 10th–90th $135$3390%10%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
$134.90
Median
$169.82
Typical High
$199.53
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$186.21
Typical High
$346.74
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$218.78
Typical High
$281.84
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$141.25
Typical High
$229.09
CareSource
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$186.21
Typical High
$251.19
CareSource
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$223.87
Typical High
$288.40
Cigna
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$251.19
Typical High
$251.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$251.19
Typical High
$1,000.00
Molina
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$165.96
Typical High
$223.87
United
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$263.03
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$213.80
Typical High
$331.13