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Hospital Consultation, Lower Complexity

West Virginia 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?

$97.72

Typical negotiated rate. In West Virginia, July 2026.

Insurers have agreed to pay about $97.72 for this service. The price depends on where it is billed: about $97.72 from a physician practice, and about $8.13 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 4 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$97.72$61.66 to $132
FacilityA hospital or hospital-owned outpatient department$8.13$7.24 to $112

How much rates vary

Facilitymedian $8 · 10th to 90th $7 to $132Professionalmedian $98 · 10th to 90th $46 to $155
$10$20$50$100$200facility $8professional $98

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
$7.24
Median
$7.24
Typical High
$131.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$97.72
Typical High
$154.88
CareSource
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$75.86
Typical High
$89.13
CareSource
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$79.43
Typical High
$109.65
Cigna
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$97.72
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$141.25
Typical High
$338.84
United
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
United
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$79.43
Typical High
$114.82

Where West Virginia 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.

West Virginia· 34th of 51

$97.72

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.