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Hospital Consultation, Lower Complexity

New Jersey 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?

$91.20

Typical physician fee. In New Jersey, July 2026.

Insurers have agreed to pay about $91.20 for this service. Most negotiated rates run $63.10 to $129.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $63 · 10th to 90th $47 to $100Professionalmedian $93 · 10th to 90th $47 to $155
$5$10$20$50$100$200facility $63professional $93

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
$46.77
Median
$63.10
Typical High
$100.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$95.50
Typical High
$154.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$100.00
Typical High
$190.55
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$95.50
Typical High
$165.96
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$85.11
Typical High
$138.04
United
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$66.07
Typical High
$87.10
United
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$79.43
Typical High
$147.91

Where New Jersey 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.

New Jersey· 41st of 51

$91.20

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.