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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 October 2026.

How much does Comprehensive Specialist Consultation Visit cost?

$214

Typical physician fee. In Rhode Island, October 2026.

Insurers have agreed to pay about $214 for this service. Most negotiated rates run $204 to $245.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $372 · 10th to 90th $251 to $537Professionalmedian $214 · 10th to 90th $178 to $282
$200$500facility $372professional $214

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$213.80
Median
$213.80
Typical High
$251.19
Aetna
Setting
Professional
Modifier
None
Typical Low
$208.93
Median
$239.88
Typical High
$281.84
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$107.15
Median
$107.15
Typical High
$125.89
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$32.36
Median
$32.36
Typical High
$38.02
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$21.38
Median
$21.38
Typical High
$25.12
BCBS Rhode Island
Setting
Facility
Modifier
None
Typical Low
$323.59
Median
$407.38
Typical High
$537.03
BCBS Rhode Island
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$204.17
Typical High
$239.88
Cigna
Setting
Professional
Modifier
None
Typical Low
$177.83
Median
$204.17
Typical High
$239.88
United
Setting
Professional
Modifier
None
Typical Low
$181.97
Median
$213.80
Typical High
$288.40

Where Rhode Island sits

The same service costs 2.4 times more in Alaska than in Alabama. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Rhode Island· 21st of 51

$214

AK $380AL $158

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.