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Hospital Consultation, Lower Complexity

Missouri 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?

$97.72

Typical negotiated rate. In Missouri, July 2026.

Insurers have agreed to pay about $97.72 for this service. The price depends on where it is billed: about $97.72 from a physician practice, and about $95.50 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$70.79 to $132
FacilityA hospital or hospital-owned outpatient department$95.50$70.79 to $120

How much rates vary

Facilitymedian $95 · 10th to 90th $60 to $141Professionalmedian $98 · 10th to 90th $60 to $219
$50$100$200facility $95professional $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
$60.26
Median
$93.33
Typical High
$123.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$104.71
Typical High
$223.87
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$67.61
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$81.28
Typical High
$125.89
BCBS
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$75.86
Typical High
$123.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$97.72
Cigna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$95.50
Typical High
$151.36
Medica
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$117.49
Typical High
$229.09
Medica
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$89.13
Typical High
$524.81
United
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$70.79
Typical High
$93.33
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$81.28
Typical High
$128.82

Where Missouri 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.

Missouri· 35th of 51

$97.72

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.