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Tennessee 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 $166 · 10th–90th $129–$3310%20%10th90th$166Professionalmedian $182 · 10th–90th $123–$5250%5%10%10th90th$182$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
$128.82 / $151.36 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $181.97 / $512.86
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $154.88 / $194.98
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $190.55 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $213.80 / $302.00
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,000.00
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,000.00
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $162.18 / $194.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $100.00 / $165.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $186.21 / $323.59