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Nebraska 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 $269 · 10th–90th $166–$4370%10%20%10th90th$269Professionalmedian $195 · 10th–90th $138–$3020%20%10th90th$195$0.2$1.0$5.0$20.0$100.0$500.0

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
$151.36 / $371.54 / $436.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $190.55 / $269.15
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $288.40 / $398.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $223.87 / $309.03
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $263.03 / $416.87
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $371.54 / $1,348.96
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $416.87 / $512.86
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $416.87 / $512.86
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $204.17 / $467.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.23 / $75.86 / $281.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $269.15 / $457.09