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Montana 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 $240 · 10th–90th $204–$2950%20%40%10th90th$240Professionalmedian $182 · 10th–90th $129–$4790%10%10th90th$182$10.0$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
$128.82 / $181.97 / $478.63
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $208.93 / $275.42
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $239.88 / $281.84
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $239.88 / $281.84
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $218.78 / $407.38
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $218.78 / $346.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $269.15 / $323.59