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New Jersey 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 $62 · 10th–90th $46–$1000%20%10th90th$62Professionalmedian $110 · 10th–90th $54–$1660%10%10th90th$110$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
$45.71 / $61.66 / $100.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $112.20 / $173.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $100.00 / $190.55
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $95.50 / $144.54
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $83.18 / $134.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $66.07 / $87.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $79.43 / $138.04