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Hospital Consultation, Lower Complexity

Utah 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?

$105

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $105 for this service. The price depends on where it is billed: about $105 from a physician practice, and about $115 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$105$75.86 to $135
FacilityA hospital or hospital-owned outpatient department$115$75.86 to $135

How much rates vary

Facilitymedian $115 · 10th to 90th $76 to $135Professionalmedian $105 · 10th to 90th $59 to $170
$10$20$50$100$200facility $115professional $105

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
$75.86
Median
$114.82
Typical High
$134.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$104.71
Typical High
$169.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$107.15
Typical High
$173.78
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$120.23
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$97.72
Typical High
$128.82
Select Health
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$97.72
Select Health
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$89.13
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$100.00
Typical High
$141.25
United
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$95.50
Typical High
$128.82

Where Utah 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.

Utah· 30th of 51

$105

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.