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Hospital Consultation, Moderate Complexity

Maryland rates for HCPCS 99254

This describes a visit where one physician asks another physician, usually a specialist, to evaluate a hospitalized patient and give an opinion or recommendation on a moderately complex medical problem. The consulting physician reviews the case, examines the patient, and documents findings and recommendations back to the physician who requested the opinion.

Rates data updated July 2026.

How much does Hospital Consultation, Moderate Complexity cost?

$195

Typical physician fee. In Maryland, July 2026.

Insurers have agreed to pay about $195 for this service. Most negotiated rates run $141 to $389.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $141 · 10th to 90th $89 to $166Professionalmedian $200 · 10th to 90th $117 to $575
$10.0$20.0$50.0$100.0$200.0$500.0$1.0Kfacility $141professional $200

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$141.25
Typical High
$165.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$199.53
Typical High
$588.84
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$117.49
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$208.93
Typical High
$331.13
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$165.96
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$199.53
Typical High
$316.23
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$186.21
Typical High
$213.80

Where Maryland sits

The same service costs 2.0 times more in South Dakota than in Washington, DC. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Maryland $195 · 10th of 51
SD $263DC $132

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.