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Rhode Island 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 $251 · 10th–90th $214–$2510%20%40%10th$251Professionalmedian $195 · 10th–90th $138–$2690%10%10th90th$195$10.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $251.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $190.55 / $269.15
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $363.08 / $645.65
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $204.17 / $323.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $257.04 / $407.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $245.47 / $416.87