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Comprehensive Specialist Consultation Visit

West 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.

How much does Comprehensive Specialist Consultation Visit cost?

$178

Typical negotiated rate. In West Virginia, July 2026.

Insurers have agreed to pay about $178 for this service. The price depends on where it is billed: about $178 from a physician practice, and about $170 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 4 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$178$148 to $204
FacilityA hospital or hospital-owned outpatient department$170$21.38 to $191

How much rates vary

Facilitymedian $170 · 10th to 90th $19 to $224Professionalmedian $178 · 10th to 90th $120 to $240
$20$50$100$200facility $170professional $178

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$18.62
Median
$21.38
Typical High
$223.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$173.78
Typical High
$234.42
CareSource
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$186.21
Typical High
$229.09
CareSource
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$208.93
Typical High
$288.40
Cigna
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$251.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$239.88
Typical High
$1,000.00
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$199.53
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$218.78
Typical High
$354.81

Where West Virginia 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.

West Virginia· 51st of 51

$178

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.