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

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

- Insurer: EmblemHealth
- Billing code: 99243 (Office visits)
- Price shown: negotiated in-network price, office, doctor's fee
- Prices as of: 2026-08-01
- All of the insurer's plans pooled; the map also shows single networks

| State | Providers | Lowest | 25th pct | Median | 75th pct | Highest |
|---|---|---|---|---|---|---|
| Alabama | 533 | $55.00 | $65.00 | $65.00 | $68.00 | $236.60 |
| Alaska | 69 | $55.00 | $55.00 | $100.00 | $100.00 | $229.27 |
| Arizona | 436 | $48.30 | $65.00 | $65.00 | $69.00 | $236.60 |
| Arkansas | 231 | $55.00 | $65.00 | $65.00 | $67.50 | $272.38 |
| California | 6,769 | $37.50 | $65.00 | $93.00 | $111.00 | $636.13 |
| Colorado | 3,761 | $55.00 | $55.00 | $65.00 | $65.00 | $272.38 |
| Connecticut | 4,598 | $48.30 | $55.00 | $75.00 | $75.00 | $636.13 |
| Delaware | 128 | $55.00 | $65.00 | $72.00 | $135.21 | $272.38 |
| District of Columbia | 189 | $55.00 | $69.00 | $69.00 | $85.00 | $636.13 |
| Florida | 3,194 | $36.00 | $65.00 | $75.00 | $75.00 | $636.13 |
| Georgia | 1,115 | $37.50 | $65.00 | $69.00 | $69.00 | $272.38 |
| Guam | 2 | $55.00 | $62.50 | $70.00 | $77.50 | $85.00 |
| Hawaii | 78 | $55.00 | $65.00 | $65.00 | $110.00 | $236.60 |
| Idaho | 243 | $55.00 | $65.00 | $65.00 | $65.00 | $116.00 |
| Illinois | 2,288 | $48.30 | $65.00 | $65.00 | $65.00 | $636.13 |
| Indiana | 908 | $55.00 | $55.00 | $65.00 | $65.00 | $636.13 |
| Iowa | 341 | $55.00 | $55.00 | $65.00 | $65.00 | $236.60 |
| Kansas | 800 | $55.00 | $55.00 | $65.00 | $65.00 | $272.38 |
| Kentucky | 1,087 | $55.00 | $55.00 | $65.00 | $65.00 | $236.60 |
| Louisiana | 607 | $48.30 | $72.00 | $72.00 | $72.00 | $636.13 |
| Maine | 292 | $55.00 | $55.00 | $65.00 | $65.00 | $636.13 |
| Maryland | 1,713 | $36.00 | $69.00 | $69.00 | $69.00 | $636.13 |
| Massachusetts | 3,891 | $36.00 | $65.00 | $66.95 | $66.95 | $636.13 |
| Michigan | 2,948 | $37.50 | $60.00 | $60.00 | $65.00 | $636.13 |
| Minnesota | 704 | $55.00 | $65.00 | $65.00 | $65.00 | $636.13 |
| Mississippi | 165 | $48.30 | $65.00 | $65.00 | $69.00 | $170.43 |
| Missouri | 1,232 | $55.00 | $55.00 | $65.00 | $65.00 | $636.13 |
| Montana | 75 | $36.00 | $65.00 | $65.00 | $69.00 | $186.46 |
| Nebraska | 207 | $55.00 | $65.00 | $65.00 | $67.00 | $170.43 |
| Nevada | 666 | $55.00 | $55.00 | $65.00 | $65.00 | $236.60 |
| New Hampshire | 1,232 | $37.50 | $55.00 | $65.00 | $65.00 | $450.70 |
| New Jersey | 6,904 | $37.50 | $72.00 | $170.43 | $170.43 | $636.13 |
| New Mexico | 219 | $37.50 | $60.00 | $60.00 | $69.00 | $272.38 |
| New York | 18,072 | $27.00 | $67.00 | $135.00 | $170.43 | $636.13 |
| North Carolina | 1,088 | $36.00 | $65.00 | $66.00 | $69.00 | $636.13 |
| North Dakota | 48 | $55.00 | $65.00 | $84.00 | $84.00 | $170.43 |
| Ohio | 2,350 | $37.50 | $55.00 | $65.00 | $65.00 | $636.13 |
| Oklahoma | 374 | $55.00 | $60.00 | $60.00 | $60.00 | $272.38 |
| Oregon | 328 | $37.50 | $65.00 | $65.00 | $75.00 | $636.13 |
| Pennsylvania | 4,788 | $36.00 | $66.00 | $170.43 | $186.46 | $636.13 |
| Puerto Rico | 12 | $55.00 | $67.00 | $75.00 | $104.00 | $236.60 |
| Rhode Island | 225 | $55.00 | $65.00 | $65.00 | $75.00 | $272.38 |
| South Carolina | 360 | $55.00 | $65.00 | $65.00 | $75.00 | $272.38 |
| South Dakota | 79 | $55.00 | $65.00 | $65.00 | $65.00 | $132.74 |
| Tennessee | 750 | $36.00 | $65.00 | $65.00 | $80.00 | $272.38 |
| Texas | 4,166 | $48.30 | $67.00 | $69.00 | $69.00 | $636.13 |
| U.S. Virgin Islands | 1 | $55.00 | $58.50 | $62.00 | $65.50 | $69.00 |
| Utah | 318 | $55.00 | $65.00 | $65.00 | $75.00 | $272.38 |
| Vermont | 260 | $55.00 | $65.00 | $65.00 | $65.00 | $236.60 |
| Virginia | 3,380 | $48.30 | $55.00 | $69.00 | $69.00 | $636.13 |
| Washington | 834 | $36.00 | $65.00 | $65.00 | $77.00 | $272.38 |
| West Virginia | 168 | $49.75 | $66.00 | $68.00 | $69.00 | $450.70 |
| Wisconsin | 1,073 | $55.00 | $55.00 | $65.00 | $65.00 | $636.13 |
| Wyoming | 87 | $55.00 | $55.00 | $65.00 | $65.00 | $114.58 |

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/emblem/statemap_99243_US.html  
About this insurer's data, and its other procedures: [index.md](index.md)