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Arizona 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.

Facilitymedian $89 · 10th–90th $55–$5010%20%10th90th$89Professionalmedian $107 · 10th–90th $55–$2040%5%10%10th90th$107$5.0$10.0$20.0$50.0$100.0$200.0$500.0

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $109.65 / $204.17
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $70.79
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $354.81 / $645.65
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $64.57 / $426.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $87.10 / $151.36
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $81.28 / $165.96
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $91.20 / $524.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $79.43 / $162.18