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Comprehensive Specialist Consultation Visit

Washington 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 $269 · 10th–90th $174$4570%10%10th90th$269Professionalmedian $204 · 10th–90th $145$5500%10%10th90th$204$10.0$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
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$316.23
Typical High
$489.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$204.17
Typical High
$616.60
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$218.78
Typical High
$398.11
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$302.00
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$181.97
Cigna
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$251.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$288.40
Typical High
$549.54
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$263.03
Typical High
$457.09
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$257.04
Typical High
$446.68
Molina
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$154.88
Typical High
$309.03
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$416.87
Typical High
$426.58
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$371.54
Typical High
$562.34
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$302.00
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$181.97
United
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$141.25
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$295.12
Typical High
$512.86
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$234.42
Typical High
$371.54