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Florida 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 $58 · 10th–90th $54–$1410%20%10th90th$58Professionalmedian $123 · 10th–90th $58–$2400%5%10%10th90th$123$5.0$20.0$100.0$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
$53.70 / $57.54 / $141.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $123.03 / $239.88
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $107.15 / $158.49
AvMed
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $75.86 / $79.43
AvMed
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $77.62 / $83.18
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
$61.66 / $93.33 / $162.18
Florida Blue
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $52.48 / $87.10
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $36.31 / $97.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $58.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $81.28 / $154.88
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $74.13