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Arizona rates for HCPCS 99254

Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.

Facilitymedian $347 · 10th–90th $132–$1,2300%5%10%10th90th$347Professionalmedian $170 · 10th–90th $115–$5620%10%10th90th$170$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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
$112.20 / $112.20 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $169.82 / $575.44
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $134.90 / $186.21
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $776.25 / $1,412.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $120.23 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $177.83 / $331.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $158.49 / $316.23
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $199.53 / $1,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $165.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $173.78 / $338.84