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Comprehensive Specialist Consultation Visit

Maryland 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 $132$2450%10%20%10th90th$174Professionalmedian $191 · 10th–90th $132$3020%10%10th90th$191$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$181.97
Typical High
$239.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$190.55
Typical High
$288.40
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$114.82
Typical High
$186.21
Cigna
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
Cigna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$234.42
Typical High
$354.81
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$229.09
Typical High
$331.13
United
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$165.96
Typical High
$218.78
United
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$229.09
Typical High
$389.05
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$213.80
Typical High
$309.03