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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 October 2026.

How much does Comprehensive Specialist Consultation Visit cost?

$224

Typical physician fee. In North Dakota, October 2026.

Insurers have agreed to pay about $224 for this service. Most negotiated rates run $191 to $316.

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.

How much rates vary

Facilitymedian $191 · 10th to 90th $170 to $229Professionalmedian $224 · 10th to 90th $170 to $447
$200$500$1Kfacility $191professional $224

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$169.82
Median
$190.55
Typical High
$223.87
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$95.50
Median
$97.72
Typical High
$112.20
Aetna
Setting
Facility
Modifier
55 · Aftercare only
Typical Low
$28.84
Median
$29.51
Typical High
$33.88
Aetna
Setting
Facility
Modifier
56 · Pre-op care only
Typical Low
$19.05
Median
$19.50
Typical High
$22.39
Aetna
Setting
Professional
Modifier
None
Typical Low
$169.82
Median
$190.55
Typical High
$281.84
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$95.50
Median
$97.72
Typical High
$112.20
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$28.84
Median
$29.51
Typical High
$33.88
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$19.05
Median
$19.50
Typical High
$22.39
Cigna
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$229.09
Typical High
$331.13
Medica
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$223.87
Typical High
$575.44
Medica
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$398.11
Typical High
$1,348.96
United
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$263.03
Typical High
$446.68

Where North Dakota sits

The same service costs 2.4 times more in Alaska than in Alabama. 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· 19th of 51

$224

AK $380AL $158

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.