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Oregon 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 $269 · 10th–90th $155–$3470%10%20%10th90th$269Professionalmedian $191 · 10th–90th $123–$5890%10%10th90th$191$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
$151.36 / $302.00 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $181.97 / $588.84
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
$190.55 / $316.23 / $457.09
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $295.12 / $346.74
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $223.87 / $363.08
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $263.03 / $457.09
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $269.15 / $323.59
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $208.93 / $363.08
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $309.03 / $416.87
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $398.11 / $575.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $295.12 / $436.52