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West 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 $76 · 10th–90th $7–$1320%20%10th90th$76Professionalmedian $98 · 10th–90th $52–$1620%10%10th90th$98$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
$7.08 / $7.24 / $131.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $97.72 / $162.18
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $85.11 / $120.23
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $141.25 / $158.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $141.25 / $331.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $79.43 / $125.89