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Washington 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 $126 · 10th–90th $79–$1740%10%20%10th90th$126Professionalmedian $123 · 10th–90th $58–$2190%10%10th90th$123$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
$79.43 / $125.89 / $162.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $123.03 / $239.88
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $131.83
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $104.71 / $208.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $134.90 / $208.93
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $138.04 / $177.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $141.25 / $177.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $67.61 / $134.90
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $138.04 / $144.54
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $104.71 / $208.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $85.11 / $123.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $104.71 / $194.98
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $81.28 / $144.54