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Montana 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 $309 · 10th–90th $195–$3890%10%20%10th90th$309Professionalmedian $200 · 10th–90th $145–$4470%10%10th90th$200$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
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $194.98 / $457.09
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $281.84 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $245.47 / $380.19
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $338.84 / $380.19
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $338.84 / $380.19
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $263.03 / $436.52
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $331.13 / $575.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $309.03 / $398.11