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Oregon 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 $316 · 10th–90th $186–$4370%20%10th90th$316Professionalmedian $219 · 10th–90th $148–$5370%20%10th90th$219$2.0$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$218.78 / $416.87 / $724.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $204.17 / $602.56
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
$190.55 / $338.84 / $512.86
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $407.38 / $501.19
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $263.03 / $426.58
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $363.08 / $501.19
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $416.87 / $426.58
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $263.03 / $436.52
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $398.11 / $524.81
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $457.09 / $891.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $281.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $354.81 / $524.81