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: Kaiser Permanente
Prices shown: in-person office visits only
Doctor’s fee or facility fee? This mixes two kinds of price : 89% are doctors' fees, 8% are facility fees paid to a hospital or surgery center and 3% cover both. Facility fees are usually far higher, so a wide spread can be the two kinds side by side, not providers charging wildly different amounts. Either way, expect a doctor's fee and a facility fee as separate bills when this is done in a hospital or surgery center. Where a state has both, the table and each state’s popup show the doctor’s fee and the facility fee side by side ; their sum is a rough total for the visit, before anything else done during it.
Who is counted: Kaiser Permanente lists clinicians individually: 95% of the 862,255 provider IDs (NPIs) it names are individual doctors, nurse practitioners and therapists; the rest are practices, clinics and hospitals. “Providers” counts those IDs.
Procedure
Breast lump removal (open surgery) Heart valve surgery with catheterization (hospital stay) Shoulder arthroscopy for impingement Knee arthroscopy - torn cartilage trim Blood draw Tonsil and adenoid removal (under 12) Upper endoscopy (diagnostic) Upper endoscopy with biopsy Colonoscopy (diagnostic) Colonoscopy with biopsy Colonoscopy with polyp removal Colonoscopy with ultrasound Spinal fusion, lower back (hospital stay) Hip or knee replacement (hospital stay) Neck spinal fusion (hospital stay) Gallbladder removal (laparoscopic) Groin hernia repair (age 5+) Prostate biopsy Prostate removal for cancer (laparoscopic) Vaginal childbirth - full maternity care C-section - full maternity care Vaginal birth after cesarean - full maternity care Epidural steroid injection, lower back (no imaging) Epidural steroid injection, lower back (with imaging) Nerve root steroid injection, lower back Laser fix for cloudy vision after cataract surgery Cataract surgery with lens implant CT scan of the head (no dye) MRI of the brain (no dye) MRI of the brain (with and without dye) Chest X-ray (single view) Chest X-ray (two views) Lower back X-ray (4+ views) MRI of the lower back (no dye) CT scan of the pelvis (with dye) MRI of a leg joint (no dye) CT scan of abdomen and pelvis (with dye) Uterus or ovary surgery, non-cancer (hospital stay) Abdominal ultrasound (complete) Pregnancy ultrasound (after 14 weeks) Transvaginal pelvic ultrasound Diagnostic mammogram, one breast Diagnostic mammogram, both breasts Screening mammogram (routine) Basic metabolic panel (BMP) Comprehensive metabolic panel (CMP) Pregnancy blood test panel Cholesterol test (lipid panel) Kidney function panel Liver function panel Urine test with microscope (manual) Urine test with microscope (automated) Basic urine test (manual) Basic urine test (automated) Hemoglobin A1c (3-month blood sugar) PSA prostate blood test (total) PSA prostate blood test (free) Thyroid blood test (TSH) Complete blood count with differential (CBC) Complete blood count (CBC, basic) Blood clotting time test (PT/INR) Blood clotting test (PTT) Therapy session (30 minutes) Therapy session (45 minutes) Therapy session (60 minutes) Family therapy (without the patient present) Family or couples therapy (patient present) Group therapy session Electrocardiogram (EKG) Heart catheterization (left heart) Overnight sleep study (in a lab) Physical therapy - therapeutic exercise (15 min) Physical therapy - balance and coordination (15 min) Physical therapy - hands-on manual therapy (15 min) Physical therapy - functional activities (15 min) Office visit, new patient (short) Office visit, new patient (standard) Office visit, new patient (extended) Office visit, new patient (complex) Quick office visit, existing patient Office visit, existing patient (short) Office visit, existing patient (standard) Office visit, existing patient (extended) Office visit, existing patient (complex) Hospital bedside visit, moderate (per day) Hospital bedside visit, high complexity (per day) Specialist consultation (standard) Specialist consultation (extended) Emergency room visit (low complexity) Emergency room visit (moderate complexity) Emergency room visit (high complexity) Emergency room visit (most complex) Annual checkup, new patient (age 18-39) Annual checkup, new patient (age 40-64) Annual checkup, existing patient (age 18-39) Annual checkup, existing patient (age 40-64) Screening colonoscopy (average risk) Home health visit by a registered nurse (15 min)
Plan
All plans Kaiser Permanente Insurance Company First Choice Health (partner network) Beacon behavioral health (partner network) Kaiser Mid-Atlantic (MD/VA/DC) Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. Kaiser Colorado Kaiser Foundation Health Plan of Colorado Kaiser Washington Kaiser Northern California Kaiser Foundation Health Plan, Inc., on behalf of the Northern California Region Kaiser Northwest (OR/WA) Kaiser Foundation Health Plan of the Northwest
Specialty All specialties Counselor Social Worker Nurse Practitioner Physician Assistant Internal Medicine Physical Therapist Student in an Organized Health Care Education/Training Program Family Medicine Psychologist Marriage & Family Therapist Pediatrics Pharmacist Emergency Medicine Registered Nurse Anesthesiology Psychiatry Chiropractor Diagnostic Radiology Massage Therapist Obstetrics & Gynecology Nurse Anesthetist, Certified Registered Acupuncturist Occupational Therapist Optometrist Speech-Language Pathologist Neurology Anatomic Pathology & Clinical Pathology Clinical Neuropsychologist Clinical Nurse Specialist Other / not stated