go back

Hospital Consultation, Lower Complexity

Michigan 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?

$93.33

Typical negotiated rate. In Michigan, July 2026.

Insurers have agreed to pay about $93.33 for this service. The price depends on where it is billed: about $97.72 from a physician practice, and about $77.62 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$97.72$69.18 to $129
FacilityA hospital or hospital-owned outpatient department$77.62$77.62 to $77.62

How much rates vary

Facilitymedian $78 · 10th to 90th $65 to $78Professionalmedian $98 · 10th to 90th $58 to $166
$50$100$200facility $78professional $98

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
$57.54
Median
$77.62
Typical High
$77.62
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$95.50
Typical High
$169.82
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$79.43
Typical High
$131.83
BCBS
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$107.15
BCBS
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$107.15
Typical High
$114.82
CareSource
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$85.11
Typical High
$91.20
CareSource
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$91.20
Typical High
$107.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$77.62
Typical High
$141.25
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$77.62
Typical High
$213.80
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$89.13
Typical High
$158.49
United
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$93.33
Typical High
$104.71
United
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$89.13
Typical High
$173.78

Where Michigan 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.

Michigan· 38th of 51

$93.33

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.