# Specialist consultation (standard): what Centene pays, by state

A specialist's opinion visit, requested by another doctor, about 40 minutes.

- Insurer: Centene (Ambetter, Health Net, Fidelis, QualChoice)
- Billing code: 99243 (Office visits)
- Price shown: negotiated in-network price, office, doctor's fee
- Prices as of: 2026-08-31
- All of the insurer's plans pooled; the map also shows single networks

| State | Providers | Lowest | 25th pct | Median | 75th pct | Highest |
|---|---|---|---|---|---|---|
| Alabama | 425 | $91.60 | $108.00 | $115.20 | $167.94 | $601.10 |
| Alaska | 64 | $93.26 | $107.11 | $109.86 | $167.87 | $601.10 |
| Arizona | 652 | $66.30 | $108.00 | $112.00 | $167.94 | $601.10 |
| Arkansas | 221 | $74.70 | $106.84 | $109.72 | $131.66 | $601.10 |
| California | 1,353 | $66.30 | $108.35 | $120.84 | $168.12 | $601.10 |
| Colorado | 609 | $66.30 | $108.00 | $115.20 | $158.61 | $601.10 |
| Connecticut | 191 | $91.60 | $109.72 | $150.82 | $196.46 | $601.10 |
| Delaware | 2,741 | $74.70 | $167.87 | $167.87 | $167.87 | $601.10 |
| District of Columbia | 122 | $84.75 | $109.72 | $149.96 | $168.60 | $601.10 |
| Florida | 9,263 | $66.30 | $143.13 | $168.12 | $196.46 | $601.10 |
| Georgia | 10,474 | $66.30 | $108.00 | $155.00 | $214.68 | $601.10 |
| Guam | 3 | $102.71 | $109.07 | $135.40 | $161.71 | $231.70 |
| Hawaii | 84 | $91.60 | $109.72 | $142.75 | $180.70 | $256.26 |
| Idaho | 148 | $92.80 | $109.72 | $144.23 | $230.10 | $256.26 |
| Illinois | 5,530 | $66.30 | $109.72 | $196.95 | $231.70 | $601.10 |
| Indiana | 12,615 | $66.30 | $107.11 | $107.11 | $149.96 | $601.10 |
| Iowa | 146 | $84.75 | $107.11 | $115.12 | $151.69 | $601.10 |
| Kansas | 3,846 | $66.30 | $106.06 | $106.06 | $137.88 | $601.10 |
| Kentucky | 15,137 | $66.30 | $106.84 | $106.84 | $122.60 | $601.10 |
| Louisiana | 380 | $66.30 | $108.00 | $109.72 | $151.77 | $601.10 |
| Maine | 119 | $66.30 | $108.35 | $122.60 | $168.12 | $343.20 |
| Maryland | 601 | $74.70 | $109.72 | $144.23 | $167.87 | $601.10 |
| Massachusetts | 358 | $66.30 | $109.72 | $142.75 | $168.12 | $601.10 |
| Michigan | 3,292 | $74.70 | $108.79 | $108.79 | $142.75 | $601.10 |
| Minnesota | 509 | $74.70 | $108.00 | $119.60 | $196.46 | $601.10 |
| Mississippi | 834 | $91.60 | $142.56 | $142.56 | $142.56 | $360.00 |
| Missouri | 1,280 | $74.70 | $106.84 | $129.00 | $158.61 | $601.10 |
| Montana | 79 | $74.70 | $108.35 | $143.49 | $213.30 | $256.26 |
| Nebraska | 121 | $74.70 | $106.84 | $109.72 | $151.69 | $601.10 |
| Nevada | 4,000 | $84.75 | $112.00 | $112.00 | $149.96 | $601.10 |
| New Hampshire | 95 | $91.60 | $109.04 | $129.00 | $168.12 | $601.10 |
| New Jersey | 395 | $66.30 | $109.72 | $142.75 | $167.87 | $601.10 |
| New Mexico | 287 | $66.30 | $106.09 | $109.72 | $120.84 | $601.10 |
| New York | 874 | $66.30 | $109.72 | $129.00 | $168.12 | $601.10 |
| North Carolina | 11,612 | $66.30 | $151.77 | $168.12 | $214.68 | $601.10 |
| North Dakota | 58 | $90.15 | $108.00 | $115.20 | $168.12 | $256.26 |
| Ohio | 21,863 | $66.30 | $113.77 | $135.43 | $151.69 | $601.10 |
| Oklahoma | 1,329 | $66.30 | $109.72 | $127.82 | $138.48 | $601.10 |
| Oregon | 435 | $66.30 | $112.00 | $168.12 | $230.10 | $601.10 |
| Pennsylvania | 1,392 | $66.30 | $115.12 | $151.69 | $167.94 | $601.10 |
| Puerto Rico | 48 | $66.30 | $109.72 | $166.99 | $196.46 | $601.10 |
| Rhode Island | 48 | $92.80 | $109.72 | $144.23 | $168.12 | $601.10 |
| South Carolina | 994 | $66.30 | $129.00 | $168.12 | $211.26 | $601.10 |
| South Dakota | 40 | $84.75 | $108.35 | $122.60 | $151.69 | $343.20 |
| Tennessee | 1,710 | $74.70 | $108.00 | $119.60 | $139.89 | $601.10 |
| Texas | 46,243 | $66.30 | $102.71 | $109.72 | $115.20 | $601.10 |
| U.S. Virgin Islands | 4 | $93.26 | $109.04 | $142.75 | $167.47 | $196.46 |
| Utah | 211 | $66.30 | $109.72 | $113.77 | $167.94 | $601.10 |
| Vermont | 27 | $93.26 | $109.72 | $129.24 | $157.89 | $601.10 |
| Virginia | 677 | $66.30 | $108.35 | $129.24 | $168.12 | $601.10 |
| Washington | 5,648 | $66.30 | $212.84 | $230.10 | $233.03 | $601.10 |
| West Virginia | 292 | $91.60 | $108.35 | $135.43 | $151.77 | $360.00 |
| Wisconsin | 448 | $66.30 | $108.35 | $142.60 | $196.95 | $601.10 |
| Wyoming | 45 | $93.26 | $108.00 | $115.20 | $168.12 | $360.00 |

Prices are what the insurer has agreed to pay, not what you will be billed. This is a statewide summary: prices vary far more between towns and between practices than these medians suggest, and "providers" counts everyone with a contracted price, not only those who perform the procedure.

Map: https://medicalpricetransparency.netlify.app/insurers/centene/statemap_99243_US.html  
About this insurer's data, and its other procedures: [index.md](index.md)