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New Mexico 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 $257 · 10th–90th $174–$3720%10%10th90th$257Professionalmedian $195 · 10th–90th $138–$3240%10%10th90th$195$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
$141.25 / $281.84 / $338.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $194.98 / $288.40
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $204.17 / $245.47
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
$181.97 / $251.19 / $363.08
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $213.80 / $316.23
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $257.04 / $389.05
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $281.84 / $489.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $281.84 / $288.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $275.42 / $407.38