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Nationwide rates for HCPCS 99252

Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $85.11 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $112.20 / $194.98
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $77.62 / $194.98
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $85.11 / $151.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.61 / $107.15 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $97.72 / $165.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.29 / $57.54 / $104.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $87.10 / $151.36