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Comprehensive Specialist Consultation Visit

North Dakota 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.

How much does Comprehensive Specialist Consultation Visit cost?

$195

Typical negotiated rate. In North Dakota, July 2026.

Insurers have agreed to pay about $195 for this service. The price depends on where it is billed: about $195 from a physician practice, and about $195 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$195$174 to $240
FacilityA hospital or hospital-owned outpatient department$195$174 to $224

How much rates vary

Facilitymedian $195 · 10th to 90th $166 to $309Professionalmedian $195 · 10th to 90th $151 to $339
$200$500facility $195professional $195

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$190.55
Typical High
$223.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$194.98
Typical High
$309.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$229.09
Typical High
$331.13
Medica
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$251.19
Typical High
$446.68
Medica
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$389.05
Typical High
$1,348.96
United
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$288.40
Typical High
$489.78

Where North Dakota sits

The same service costs 1.5 times more in Minnesota than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

North Dakota· 28th of 51

$195

MN $275WV $178

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.