Specialist consultation (standard)

A specialist's opinion visit, requested by another doctor, about 40 minutes.
Code 99243 · Office visits · statewide summary · negotiated in-network prices
Payers shown: Blue Cross Blue Shield of Massachusetts
Prices shown: every in-person setting
Doctor’s fee or facility fee? These are facility fees: what the insurer pays the hospital or surgery center itself. The doctors who treat you bill separately, on top of it.
Who is counted: Blue Cross Blue Shield of Massachusetts lists clinicians individually: 98% of the 76,809 provider IDs (NPIs) it names are individual doctors, nurse practitioners and therapists; the rest are practices, clinics and hospitals. “Providers” counts those IDs.
Not on this map: These prices come from the file set every Blue plan publishes centrally for members of other Blue plans (BlueCard). It may leave out networks the plan publishes only on its own site. Hospital stays: Blue Cross Blue Shield of Massachusetts's files have no prices for whole hospital stays (the kind billed as one amount per stay), so there are no hospital-stay maps for it. It may pay hospitals by the day or as a share of their charges, which these maps cannot show.
StateProvidersOrganisationsZip codes Lowest25th pctMedian75th pctHighest
This is a statewide summary. Prices vary far more between towns and between practices than these medians suggest; zip-code and provider-level detail is not published here; this specific data can be requested here.