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Hospital Consultation, Lower Complexity

Arizona rates for HCPCS 99252

A specialist's opinion on a hospital patient, requested by the doctor already caring for them. The consultant takes a history, examines the patient, reviews the records, and writes back with advice. This is one of the shorter consultations of its kind, for a problem that is fairly limited in complexity.

Rates data updated July 2026.

How much does Hospital Consultation, Lower Complexity cost?

$105

Typical negotiated rate. In Arizona, July 2026.

Insurers have agreed to pay about $105 for this service. The price depends on where it is billed: about $105 from a physician practice, and about $93.33 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 6 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$105$66.07 to $155
FacilityA hospital or hospital-owned outpatient department$93.33$54.95 to $339

How much rates vary

Facilitymedian $93 · 10th to 90th $55 to $501Professionalmedian $105 · 10th to 90th $55 to $240
$10$20$50$100$200$500facility $93professional $105

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
$54.95
Median
$54.95
Typical High
$54.95
Aetna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$107.15
Typical High
$239.88
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$69.18
BCBS
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$354.81
Typical High
$660.69
BCBS
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$436.52
Cigna
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$97.72
Cigna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$87.10
Typical High
$147.91
Medica
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$81.28
Typical High
$165.96
Medica
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$91.20
Typical High
$524.81
United
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$85.11
United
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$81.28
Typical High
$173.78

Where Arizona sits

The same service costs 2.3 times more in South Dakota than in Washington, DC. 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.

Arizona· 27th of 51

$105

SD $158DC $67.61

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.