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Idaho 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 $229 · 10th–90th $174–$3160%20%10th90th$229Professionalmedian $182 · 10th–90th $132–$5370%10%10th90th$182$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
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $181.97 / $537.03
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $316.23
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $269.15 / $281.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $251.19 / $354.81
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $234.42 / $316.23
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $229.09 / $426.58
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $77.62
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $309.03
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $263.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $199.53 / $295.12