go back

Georgia 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 $155 · 10th–90th $132–$2190%10%20%10th90th$155Professionalmedian $174 · 10th–90th $120–$4370%10%10th90th$174$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
$131.83 / $154.88 / $208.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $173.78 / $436.52
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $234.42 / $288.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $186.21 / $288.40
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $186.21 / $269.15
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $165.96 / $208.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $218.78 / $323.59
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $186.21 / $363.08
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $316.23 / $398.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $165.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $199.53 / $380.19