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Hospital Consultation, Lower Complexity

Kentucky 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?

$79.43

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $79.43 for this service. The price depends on where it is billed: about $79.43 from a physician practice, and about $69.18 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 7 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$79.43$61.66 to $115
FacilityA hospital or hospital-owned outpatient department$69.18$61.66 to $72.44

How much rates vary

Facilitymedian $69 · 10th to 90th $51 to $98Professionalmedian $79 · 10th to 90th $51 to $145
$50$100$200facility $69professional $79

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
$51.29
Median
$69.18
Typical High
$74.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$79.43
Typical High
$154.88
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$69.18
Typical High
$93.33
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$79.43
Typical High
$112.20
CareSource
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$85.11
Typical High
$104.71
CareSource
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$81.28
Typical High
$104.71
Cigna
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$97.72
Typical High
$97.72
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$138.04
Typical High
$338.84
Molina
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$58.88
Typical High
$75.86
United
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$93.33
United
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$81.28
Typical High
$141.25

Where Kentucky 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.

Kentucky· 45th of 51

$79.43

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.