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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.

Facilitymedian $162 · 10th–90th $102$2510%20%40%10th90th$162Professionalmedian $229 · 10th–90th $162$6920%20%10th90th$229$0.0$0.2$2.0$20.0$200.0

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
$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