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Comprehensive Specialist Consultation Visit

Virginia 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 $240 · 10th–90th $170$3720%20%10th90th$240Professionalmedian $195 · 10th–90th $135$3020%20%10th90th$195$0.0$0.2$2.0$20.0$200.0$2.0K

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
Facility
Modifier
Global
Typical Low
$151.36
Median
$177.83
Typical High
$239.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$186.21
Typical High
$275.42
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.02
Median
$158.49
Typical High
$549.54
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$114.82
Typical High
$190.55
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
$245.47
Typical High
$380.19
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$229.09
Typical High
$371.54
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
$489.78
Sentara
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$229.09
Typical High
$354.81
Sentara
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$269.15
Typical High
$416.87
United
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$162.18
Typical High
$251.19
United
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$229.09
Typical High
$407.38