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Missouri rates for HCPCS 99245

Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.

Facilitymedian $295 · 10th–90th $186–$4170%10%20%10th90th$295Professionalmedian $204 · 10th–90th $145–$4370%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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $309.03 / $363.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $199.53 / $446.68
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $213.80 / $251.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $186.21 / $316.23
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $213.80 / $302.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $275.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $245.47 / $380.19
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $251.19 / $489.78
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $281.84 / $1,348.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $125.89 / $281.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $218.78 / $338.84