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Minnesota 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 $251 · 10th–90th $120–$1,3180%10%20%10th90th$251Professionalmedian $200 · 10th–90th $123–$4900%10%10th90th$200$10.0$50.0$200.0$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
$112.20 / $128.82 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $173.78 / $501.19
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $457.09 / $1,862.09
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $323.59 / $436.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $169.82 / $371.54
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $131.83
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $234.42 / $354.81
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $338.84 / $676.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $323.59 / $512.86