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Specialist Consultation For A Hospitalized Patient

Florida rates for HCPCS 99253

This covers an initial evaluation of a hospitalized patient by a specialist at the request of another treating doctor, seeking advice or a second opinion on the patient's care. It involves a detailed review of the patient's history and a physical exam, along with medical decision-making of low complexity. The requesting doctor remains involved in the patient's care alongside the consulting specialist.

Rates data updated July 2026.

How much does Specialist Consultation For A Hospitalized Patient cost?

$129

Typical negotiated rate. In Florida, July 2026.

Insurers have agreed to pay about $129 for this service. The price depends on where it is billed: about $129 from a physician practice, and about $87.10 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 8 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$129$102 to $174
FacilityA hospital or hospital-owned outpatient department$87.10$85.11 to $97.72

How much rates vary

Facilitymedian $87 · 10th to 90th $81 to $141Professionalmedian $129 · 10th to 90th $85 to $282
$50$100$200$500facility $87professional $129

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
$81.28
Median
$87.10
Typical High
$141.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$128.82
Typical High
$288.40
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$144.54
Typical High
$199.53
AvMed
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$120.23
Typical High
$125.89
Cigna
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$138.04
Cigna
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$138.04
Typical High
$234.42
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$72.44
Typical High
$114.82
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$120.23
United
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$218.78
United
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$125.89
Typical High
$263.03
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$114.82

Where Florida sits

The same service costs 2.2 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.

Florida· 25th of 51

$129

SD $209DC $95.50

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.