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Specialist Consultation For A Hospitalized Patient

North Dakota 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?

$126

Typical physician fee. In North Dakota, July 2026.

Insurers have agreed to pay about $126 for this service. Most negotiated rates run $97.72 to $209.

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.

How much rates vary

Facilitymedian $98 · 10th to 90th $81 to $115Professionalmedian $132 · 10th to 90th $89 to $295
$100$200facility $98professional $132

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
$97.72
Typical High
$114.82
Aetna
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$131.83
Typical High
$295.12
Cigna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$107.15
Typical High
$275.42
Medica
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$141.25
Typical High
$194.98
Medica
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$204.17
Typical High
$707.95
United
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$181.97
Typical High
$269.15

Where North Dakota 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.

North Dakota· 31st of 51

$126

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.