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Illinois 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.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $85.11 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $109.65 / $199.53
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $70.79 / $199.53
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.36 / $302.00 / $1,174.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $97.72 / $141.25
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $125.89 / $346.74
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $87.10 / $93.33
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $33.88 / $93.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.61 / $67.61 / $141.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $91.20 / $138.04