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Delaware 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 $4 · 10th–90th $4–$930%50%90th$4Professionalmedian $112 · 10th–90th $55–$1950%5%10%10th90th$112$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.72 / $3.72 / $93.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $112.20 / $194.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $85.11 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $81.28 / $138.04