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New Jersey 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.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.65 / $116.33 / $145.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.65 / $143.21 / $190.95
AmeriHealth
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.36 / $242.00 / $1,121.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.53 / $218.97 / $348.86
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $158.91 / $204.91
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.16 / $181.48 / $272.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.00 / $181.79 / $316.20