Specialist consultation, level 5
CPT 99245 · Doctor and ER visits · hospital facility charge
At the 68 hospitals whose price files we have read so far, the typical cash price is $236, and most charge between $120 and $591 (the middle 80%; price files contain errors, so the extremes are left out). Pick a state to compare its hospitals.
- $38–$156
- $156–$206
- $206–$241
- $241–$489
- $489–$604
Every state
| State | Hospitals | Typical cash price | Lowest cash | Highest cash | Typical insurer price |
|---|---|---|---|---|---|
| Arizona | 1 | – | – | – | $783 |
| California | 3 | $207 | $207 | $207 | $131 |
| Connecticut | 1 | $375 | $375 | $375 | $332 |
| Florida | 7 | $253 | $236 | $269 | $177 |
| Georgia | 2 | $566 | $214 | $917 | – |
| Illinois | 3 | $200 | $200 | $200 | $1,237 |
| Indiana | 1 | – | – | – | $201 |
| Massachusetts | 1 | $583 | $583 | $583 | $559 |
| Michigan | 3 | – | – | – | $303 |
| Missouri | 2 | $179 | $179 | $179 | $229 |
| North Carolina | 3 | – | – | – | $252 |
| New Jersey | 7 | $238 | $238 | $238 | $143 |
| Nevada | 1 | – | – | – | $455 |
| New York | 1 | $604 | $604 | $604 | $376 |
| Ohio | 3 | $218 | $218 | $218 | $451 |
| Oklahoma | 2 | $140 | $140 | $140 | $194 |
| Pennsylvania | 2 | $38 | $38 | $38 | $54 |
| South Carolina | 1 | – | – | – | – |
| Tennessee | 1 | $90 | $90 | $90 | $127 |
| Texas | 19 | – | – | – | $625 |
| Utah | 2 | – | – | – | $497 |
| Virginia | 2 | – | – | – | – |
Common questions
How much does specialist consultation, level 5 cost at a hospital?
At 17 hospitals that publish a cash price, the typical price for specialist consultation, level 5 is $236, and most charge between $120 and $591. The typical rate commercial insurers have negotiated is $465. These are hospital prices; independent clinics, imaging centers and labs often charge less.
Is it cheaper to pay cash or use insurance for specialist consultation, level 5?
At 3 of the 11 hospitals that publish both, the cash price is lower than the typical insurer rate. Remember that with insurance you pay only your share of that rate once your deductible is met, and that cash payments usually don't count toward your deductible.
Does the price include the doctor?
No. These are the hospital's own charges, often called the facility fee. The doctors involved, such as the surgeon, the anesthesiologist or the radiologist who reads a scan, usually send a separate bill.
Before you go
- Ask for an estimate. Hospitals must give uninsured and self-pay patients a written good-faith estimate before planned care.
- Check the network. Confirm that the hospital and the doctors are in your plan's network.
- Ask about financial help. Non-profit hospitals must have a financial assistance policy; many discount or forgive bills by income.
- Get an itemized bill. Compare it with the estimate and question anything you don't recognise.