go back

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.

How much does Comprehensive Specialist Consultation Visit cost?

$186

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $186 for this service. The price depends on where it is billed: about $186 from a physician practice, and about $174 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 7 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$186$155 to $229
FacilityA hospital or hospital-owned outpatient department$174$151 to $200

How much rates vary

Facilitymedian $174 · 10th to 90th $135 to $251Professionalmedian $186 · 10th to 90th $135 to $339
$20$50$100$200$500facility $174professional $186

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
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

Where Kentucky 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.

Kentucky· 41st of 51

$186

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.