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Virginia 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 $79 · 10th–90th $59–$2000%10%20%10th90th$79Professionalmedian $100 · 10th–90th $55–$1550%10%20%10th90th$100$0.0$0.2$2.0$20.0$200.0$2.0K

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
$52.48 / $67.61 / $107.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $100.00 / $154.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $85.11
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $61.66 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $93.33 / $169.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $89.13 / $245.47
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $89.13 / $151.36
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $107.15 / $165.96
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $100.00
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $97.72 / $4,073.80
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $95.50 / $4,073.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $93.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $89.13 / $151.36