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Kentucky 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 $69 · 10th–90th $58–$1020%20%40%10th90th$69Professionalmedian $98 · 10th–90th $58–$1550%10%10th90th$98$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $69.18 / $97.72
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $100.00 / $154.88
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $69.18 / $93.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $79.43 / $112.20
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $87.10 / $109.65
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $81.28 / $104.71
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $109.65 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $128.82 / $331.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $57.54 / $75.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $93.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $79.43 / $131.83