go back

Utah 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 $115 · 10th–90th $76–$1350%20%10th90th$115Professionalmedian $100 · 10th–90th $54–$1660%10%10th90th$100$10.0$20.0$50.0$100.0$200.0

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
$75.86 / $114.82 / $134.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $100.00 / $165.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $107.15 / $173.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $117.49
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $97.72 / $128.82
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $102.33 / $407.38
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $100.00 / $141.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $95.50 / $128.82