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Hospital Consultation, Lower Complexity

Idaho 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?

$126

Typical negotiated rate. In Idaho, July 2026.

Insurers have agreed to pay about $126 for this service. The price depends on where it is billed: about $126 from a physician practice, and about $105 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$126$83.18 to $155
FacilityA hospital or hospital-owned outpatient department$105$102 to $141

How much rates vary

Facilitymedian $105 · 10th to 90th $85 to $170Professionalmedian $126 · 10th to 90th $63 to $257
$50$100$200facility $105professional $126

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
$102.33
Median
$102.33
Typical High
$102.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$125.89
Typical High
$257.04
BCBS
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$107.15
Typical High
$162.18
BCBS
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$141.25
Typical High
$144.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$117.49
Typical High
$162.18
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$125.89
Typical High
$204.17
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$125.89
Typical High
$147.91
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$77.62
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$112.20
Typical High
$158.49
Select Health
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$173.78
Select Health
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$131.83
United
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$93.33
United
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$95.50
Typical High
$144.54

Where Idaho 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.

Idaho· 8th of 51

$126

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.