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Specialist Consultation For A Hospitalized Patient

Nebraska 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?

$145

Typical negotiated rate. In Nebraska, July 2026.

Insurers have agreed to pay about $145 for this service. The price depends on where it is billed: about $145 from a physician practice, and about $162 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 7 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$145$95.50 to $214
FacilityA hospital or hospital-owned outpatient department$162$95.50 to $234

How much rates vary

Facilitymedian $162 · 10th to 90th $71 to $275Professionalmedian $145 · 10th to 90th $78 to $372
$100$200$500facility $162professional $145

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$81.28
Typical High
$95.50
Aetna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$123.03
Typical High
$371.54
BCBS
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$229.09
Typical High
$269.15
BCBS
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$151.36
Typical High
$204.17
Cigna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$223.87
Typical High
$245.47
Medica
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$165.96
Typical High
$467.74
Medica
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$199.53
Typical High
$707.95
Midlands
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$245.47
Typical High
$245.47
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
United
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$66.07
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$199.53
Typical High
$295.12

Where Nebraska 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.

Nebraska· 10th of 51

$145

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.