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Comprehensive Specialist Consultation Visit

Michigan 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 $195 · 10th–90th $148$2290%20%10th90th$195Professionalmedian $195 · 10th–90th $141$2750%10%10th90th$195$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
$147.91
Median
$194.98
Typical High
$229.09
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$190.55
Typical High
$263.03
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$218.78
Typical High
$346.74
BCBS
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
BCBS
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$275.42
Typical High
$295.12
CareSource
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$218.78
Typical High
$239.88
CareSource
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$263.03
Typical High
$281.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$223.87
Typical High
$371.54
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$213.80
Typical High
$245.47
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$199.53
Typical High
$302.00
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$263.03
Typical High
$602.56
United
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$141.25
Typical High
$229.09
United
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$229.09
Typical High
$380.19