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Hospital Consultation, Lower Complexity

Georgia 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?

$115

Typical negotiated rate. In Georgia, July 2026.

Insurers have agreed to pay about $115 for this service. The price depends on where it is billed: about $115 from a physician practice, and about $95.50 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 8 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$115$81.28 to $145
FacilityA hospital or hospital-owned outpatient department$95.50$69.18 to $115

How much rates vary

Facilitymedian $95 · 10th to 90th $62 to $135Professionalmedian $115 · 10th to 90th $60 to $178
$50$100$200facility $95professional $115

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
$61.66
Median
$95.50
Typical High
$134.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$114.82
Typical High
$177.83
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$107.15
Typical High
$151.36
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$87.10
Typical High
$141.25
CareSource
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$125.89
CareSource
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$89.13
Typical High
$104.71
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$97.72
Typical High
$147.91
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$95.50
Typical High
$186.21
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$72.44
Typical High
$177.83
United
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
United
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$91.20
Typical High
$177.83

Where Georgia 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.

Georgia· 16th of 51

$115

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.