go back

Comprehensive Specialist Consultation Visit

New Mexico 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.

Facilitymedian $245 · 10th–90th $174$3800%10%10th90th$245Professionalmedian $195 · 10th–90th $138$3470%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
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$194.98
Typical High
$288.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$194.98
Typical High
$302.00
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$204.17
Typical High
$245.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$251.19
Typical High
$354.81
Molina
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$213.80
Typical High
$331.13
Providence
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$257.04
Typical High
$389.05
Providence
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$281.84
Typical High
$489.78
United
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$194.98
Typical High
$288.40
United
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$275.42
Typical High
$426.58