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Comprehensive Specialist Consultation Visit

Maine 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?

$214

Typical negotiated rate. In Maine, July 2026.

Insurers have agreed to pay about $214 for this service. The price depends on where it is billed: about $219 from a physician practice, and about $191 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 6 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$219$182 to $269
FacilityA hospital or hospital-owned outpatient department$191$174 to $204

How much rates vary

Facilitymedian $191 · 10th to 90th $100 to $229Professionalmedian $219 · 10th to 90th $148 to $389
$100$200$500facility $191professional $219

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
$100.00
Median
$190.55
Typical High
$229.09
Aetna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$204.17
Typical High
$269.15
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$190.55
Typical High
$346.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$549.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$245.47
Typical High
$457.09
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$309.03
Typical High
$537.03
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$190.55
Typical High
$229.09
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$204.17
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$281.84
Typical High
$467.74

Where Maine 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.

Maine· 8th of 51

$214

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.