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Hospital Consultation, Lower Complexity

Vermont 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?

$110

Typical physician fee. In Vermont, July 2026.

Insurers have agreed to pay about $110 for this service. Most negotiated rates run $91.20 to $135.

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

Professionalmedian $110 · 10th to 90th $71 to $135
$10$20$50$100$200professional $110

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
Professional
Modifier
Global
Typical Low
$70.79
Median
$107.15
Typical High
$134.90
BCBS
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$128.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$102.33
Typical High
$169.82
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$0.05
Median
$0.05
Typical High
$0.05
United
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$107.15
Typical High
$173.78

Where Vermont 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.

Vermont· 23rd of 51

$110

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.