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Comprehensive Specialist Consultation Visit

Rhode Island 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 $251 · 10th–90th $214$2510%20%40%10th$251Professionalmedian $214 · 10th–90th $162$2820%20%10th90th$214$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
$213.80
Median
$213.80
Typical High
$251.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$213.80
Typical High
$275.42
BCBS
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$363.08
Typical High
$645.65
BCBS
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$218.78
Typical High
$323.59
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$107.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$251.19
Typical High
$416.87
United
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$223.87
Typical High
$389.05