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Utah 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 $191 · 10th–90th $166–$2240%20%40%10th90th$191Professionalmedian $204 · 10th–90th $145–$7240%10%10th90th$204$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
$165.96 / $190.55 / $223.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $204.17 / $741.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $245.47 / $389.05
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $295.12
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $263.03 / $758.58
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $257.04 / $524.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $229.09 / $363.08