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Connecticut 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 $288 · 10th–90th $148–$3470%20%40%10th90th$288Professionalmedian $170 · 10th–90th $115–$3630%10%10th90th$170$10.0$20.0$50.0$100.0$200.0$500.0

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
$147.91 / $288.40 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $169.82 / $363.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $213.80 / $302.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $199.53 / $316.23
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $208.93 / $288.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $218.78 / $371.54