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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.

How much does Comprehensive Specialist Consultation Visit cost?

$214

Typical negotiated rate. In Rhode Island, July 2026.

Insurers have agreed to pay about $214 for this service. The price depends on where it is billed: about $214 from a physician practice, and about $251 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$214$186 to $240
FacilityA hospital or hospital-owned outpatient department$251$214 to $251

How much rates vary

Facilitymedian $251 · 10th to 90th $214 to $251Professionalmedian $214 · 10th to 90th $162 to $282
$200facility $251professional $214

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

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

Where Rhode Island sits

The same service costs 1.5 times more in Minnesota than in West Virginia. 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· 9th of 51

$214

MN $275WV $178

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.