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Washington, DC 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 $132 · 10th–90th $115–$5500%20%10th90th$132Professionalmedian $166 · 10th–90th $112–$4270%10%10th90th$166$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
$114.82 / $131.83 / $549.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $165.96 / $426.58
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $134.90 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $181.97 / $309.03
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $309.03 / $323.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $173.78 / $323.59