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Comprehensive Specialist Consultation Visit

South Carolina 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 $178$3890%10%10th90th$251Professionalmedian $195 · 10th–90th $141$3470%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
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$194.98
Typical High
$346.74
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$234.42
Typical High
$346.74
BCBS
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$213.80
Typical High
$257.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$251.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$234.42
Typical High
$380.19
Medcost
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$269.15
Typical High
$331.13
Medcost
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$251.19
Typical High
$389.05
Medcost
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$141.25
Molina
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$162.18
Typical High
$218.78
United
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$128.82
United
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$213.80
Typical High
$316.23