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Missouri 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 $204 · 10th–90th $126–$2750%10%10th90th$204Professionalmedian $162 · 10th–90th $112–$3390%10%10th90th$162$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
$114.82 / $204.17 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $158.49 / $338.84
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $165.96 / $169.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $165.96 / $269.15
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $154.88 / $239.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $199.53 / $331.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $229.09 / $467.74
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $199.53 / $1,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $131.83 / $181.97
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $177.83 / $257.04