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: Anthem Blue Cross and Blue Shield
Prices shown: in-person office visits only
Doctor’s fee or facility fee? These are doctors' fees for a visit in their own office. An independent practice usually charges nothing more, but a clinic owned by a hospital may add a separate facility fee — worth asking before you book.
Who is counted: Anthem Blue Cross and Blue Shield lists clinicians individually: 88% of the 1,065,071 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: Only part of Anthem is here. These prices come from the files Anthem publishes for members of other Blue plans (BlueCard): its broad network in each state, about 88 GB. Anthem's own index lists roughly 480 more files, about 680 GB, covering some 430 narrower and employer-specific networks across its 14 states. Those have not been read, so a plan that uses one of them may pay different prices from the ones shown. Ohio: Anthem publishes its Ohio prices in the files of its Indiana plan (BlueCard plan 131), which also list many providers in other states (Missouri, Kentucky, Wisconsin, Illinois and more). These maps place every price by where the provider practises: Ohio's are listed as "Anthem Blue Cross and Blue Shield Ohio (filed under its Indiana plan)", Indiana's as Anthem Blue Cross and Blue Shield Indiana, and the rest as "Anthem's Indiana plan: providers outside Indiana and Ohio" - beside those states' own Anthem networks, whose prices differ.
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.