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West Virginia 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 $129 · 10th–90th $16–$1860%20%10th90th$129Professionalmedian $155 · 10th–90th $107–$3550%10%10th90th$155$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
$15.85 / $16.22 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $151.36 / $354.81
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $165.96 / $234.42
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $275.42 / $309.03
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 / $316.23 / $645.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $158.49 / $281.84