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Comprehensive Specialist Consultation Visit

Missouri 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 $275 · 10th–90th $178$4270%10%10th90th$275Professionalmedian $204 · 10th–90th $141$4170%10%10th90th$204$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
$234.42
Median
$309.03
Typical High
$363.08
Aetna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$199.53
Typical High
$467.74
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$218.78
Typical High
$251.19
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$186.21
Typical High
$316.23
BCBS
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$213.80
Typical High
$309.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$251.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$245.47
Typical High
$380.19
Medica
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$251.19
Typical High
$489.78
Medica
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$281.84
Typical High
$1,348.96
United
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$138.04
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$223.87
Typical High
$354.81