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Hospital Consultation, Lower Complexity

Washington, DC 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?

$67.61

Typical physician fee. In Washington, DC, July 2026.

Insurers have agreed to pay about $67.61 for this service. Most negotiated rates run $58.88 to $79.43.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $68 · 10th to 90th $59 to $251Professionalmedian $68 · 10th to 90th $55 to $79
$100$200facility $68professional $68

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
$58.88
Median
$67.61
Typical High
$251.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$67.61
Typical High
$79.43
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$77.62
Typical High
$97.72
Cigna
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$95.50
Typical High
$151.36
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$144.54
Typical High
$154.88
United
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
United
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$85.11
Typical High
$147.91

Where Washington, DC 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.

Washington, DC· 51st of 51

$67.61

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.