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Comprehensive Specialist Consultation Visit

Utah 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 $191 · 10th–90th $166$2340%20%40%10th90th$191Professionalmedian $204 · 10th–90th $132$7410%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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$190.55
Typical High
$223.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$204.17
Typical High
$741.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$251.19
Typical High
$407.38
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$346.74
Select Health
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$234.42
Select Health
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$263.03
Typical High
$831.76
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$257.04
Typical High
$524.81
United
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$229.09
Typical High
$371.54