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Nevada 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 $126 · 10th–90th $19–$2400%10%10th90th$126Professionalmedian $195 · 10th–90th $135–$3630%10%10th90th$195$2.0$10.0$50.0$200.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $177.83 / $239.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $194.98 / $363.08
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $213.80 / $309.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $158.49 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $239.88 / $346.74
Hometown Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.91 / $1.91 / $223.87
Hometown Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.91 / $1.91 / $1.91
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $208.93 / $323.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $229.09 / $371.54