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Maryland 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 $85 · 10th–90th $65–$890%20%10th90th$85Professionalmedian $112 · 10th–90th $55–$1820%10%10th90th$112$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
$64.57 / $85.11 / $89.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $114.82 / $181.97
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $58.88 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $100.00 / $158.49
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $83.18 / $144.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $91.20 / $144.54
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $83.18 / $109.65