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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.

Facilitymedian $191 · 10th–90th $100$2290%10%20%10th90th$191Professionalmedian $219 · 10th–90th $148$3890%10%10th90th$219$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
$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