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

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

- Insurer: SummaCare
- Billing code: 99243 (Office visits)
- Price shown: negotiated in-network price, office, doctor's and facility fees
- Prices as of: 2026-09-20
- All of the insurer's plans pooled; the map also shows single networks

| State | Providers | Lowest | 25th pct | Median | 75th pct | Highest |
|---|---|---|---|---|---|---|
| Alabama | 4 | $113.77 | $164.32 | $183.37 | $183.37 | $252.46 |
| Alaska | 3 | $113.77 | $121.89 | $124.60 | $128.67 | $140.86 |
| Arizona | 30 | $108.35 | $113.77 | $148.44 | $183.37 | $183.37 |
| Arkansas | 13 | $113.77 | $133.27 | $164.32 | $183.37 | $183.37 |
| California | 85 | $65.01 | $119.19 | $148.44 | $183.37 | $252.46 |
| Colorado | 21 | $113.77 | $119.19 | $148.44 | $183.37 | $183.37 |
| Connecticut | 10 | $113.77 | $116.48 | $164.32 | $183.37 | $183.37 |
| Delaware | 2 | $113.77 | $116.48 | $119.19 | $151.28 | $183.37 |
| District of Columbia | 13 | $119.19 | $130.47 | $183.37 | $183.37 | $183.37 |
| Florida | 100 | $113.77 | $119.19 | $133.27 | $171.19 | $252.46 |
| Georgia | 38 | $113.77 | $126.77 | $164.32 | $183.37 | $183.37 |
| Hawaii | 4 | $119.19 | $133.27 | $148.44 | $148.44 | $183.37 |
| Idaho | 2 | $113.77 | $113.77 | $113.77 | $113.77 | $113.77 |
| Illinois | 65 | $102.93 | $119.19 | $140.86 | $183.37 | $252.46 |
| Indiana | 37 | $113.77 | $119.19 | $140.86 | $183.37 | $252.46 |
| Iowa | 14 | $113.77 | $122.71 | $156.38 | $183.37 | $183.37 |
| Kansas | 8 | $119.19 | $129.75 | $165.91 | $183.37 | $183.37 |
| Kentucky | 33 | $108.35 | $113.77 | $124.60 | $167.76 | $183.37 |
| Louisiana | 8 | $113.77 | $113.77 | $116.48 | $142.76 | $183.37 |
| Maine | 8 | $113.77 | $117.84 | $119.19 | $183.37 | $183.37 |
| Maryland | 37 | $113.77 | $156.38 | $183.37 | $183.37 | $183.37 |
| Massachusetts | 48 | $113.77 | $148.44 | $183.37 | $183.37 | $183.37 |
| Michigan | 119 | $102.93 | $113.77 | $133.27 | $183.37 | $252.46 |
| Minnesota | 26 | $113.77 | $120.00 | $133.27 | $183.37 | $252.46 |
| Mississippi | 1 | $148.44 | $148.44 | $148.44 | $148.44 | $148.44 |
| Missouri | 28 | $113.77 | $119.19 | $140.86 | $183.37 | $183.37 |
| Montana | 2 | $119.19 | $130.47 | $141.76 | $153.04 | $164.32 |
| Nebraska | 4 | $119.19 | $119.19 | $151.28 | $183.37 | $183.37 |
| Nevada | 8 | $113.77 | $119.19 | $133.27 | $183.37 | $183.37 |
| New Hampshire | 5 | $119.19 | $124.60 | $183.37 | $183.37 | $183.37 |
| New Jersey | 22 | $97.52 | $113.77 | $128.94 | $164.32 | $252.46 |
| New Mexico | 5 | $113.77 | $124.60 | $151.69 | $183.37 | $183.37 |
| New York | 93 | $113.77 | $124.60 | $171.19 | $183.37 | $252.46 |
| North Carolina | 43 | $104.06 | $122.42 | $148.44 | $183.37 | $252.46 |
| North Dakota | 6 | $119.19 | $140.86 | $183.37 | $183.37 | $183.37 |
| Ohio | 14,060 | $81.26 | $113.77 | $124.60 | $164.32 | $252.46 |
| Oklahoma | 7 | $124.60 | $165.91 | $183.37 | $183.37 | $183.37 |
| Oregon | 7 | $113.77 | $119.19 | $148.44 | $183.37 | $183.37 |
| Pennsylvania | 181 | $108.35 | $113.77 | $148.44 | $183.37 | $252.46 |
| Rhode Island | 5 | $113.77 | $119.19 | $164.32 | $183.37 | $252.46 |
| South Carolina | 26 | $113.77 | $123.25 | $156.38 | $183.37 | $183.37 |
| South Dakota | 3 | $119.19 | $129.75 | $133.27 | $137.06 | $148.44 |
| Tennessee | 32 | $113.77 | $124.60 | $164.32 | $183.37 | $252.46 |
| Texas | 76 | $113.77 | $119.19 | $156.38 | $183.37 | $252.46 |
| Utah | 7 | $108.35 | $119.19 | $133.27 | $167.76 | $183.37 |
| Virginia | 55 | $108.35 | $133.27 | $183.37 | $183.37 | $183.37 |
| Washington | 17 | $113.77 | $119.19 | $133.27 | $183.37 | $183.37 |
| West Virginia | 24 | $113.77 | $124.60 | $148.44 | $183.37 | $252.46 |
| Wisconsin | 22 | $108.35 | $119.19 | $164.32 | $183.37 | $183.37 |
| Wyoming | 2 | $113.77 | $113.77 | $113.77 | $113.77 | $113.77 |

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