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Comprehensive Specialist Consultation Visit

Vermont 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.

How much does Comprehensive Specialist Consultation Visit cost?

$229

Typical physician fee. In Vermont, July 2026.

Insurers have agreed to pay about $229 for this service. Most negotiated rates run $195 to $288.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $162 · 10th to 90th $102 to $251Professionalmedian $229 · 10th to 90th $162 to $692
$10$20$50$100$200$500facility $162professional $229

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$114.82
Typical High
$213.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$229.09
Typical High
$724.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$389.05
Typical High
$389.05
Cigna
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$245.47
Typical High
$380.19
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$0.02
Median
$0.03
Typical High
$269.15
United
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$194.98
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$263.03
Typical High
$524.81

Where Vermont sits

The same service costs 1.5 times more in Minnesota than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Vermont· 5th of 51

$229

MN $275WV $178

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.