# Specialist consultation (standard): what UPMC Health Plan pays, by state

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

- Insurer: UPMC Health Plan
- Billing code: 99243 (Office visits)
- Price shown: negotiated in-network price, office, doctor's and facility fees
- Prices as of: 2026-09-01
- All of the insurer's plans pooled; the map also shows single networks

| State | Providers | Lowest | 25th pct | Median | 75th pct | Highest |
|---|---|---|---|---|---|---|
| Alabama | 26 | $100.44 | $136.45 | $136.45 | $136.45 | $136.45 |
| Alaska | 6 | $128.25 | $136.45 | $136.45 | $136.45 | $136.45 |
| Arizona | 56 | $81.00 | $136.45 | $136.45 | $136.45 | $137.80 |
| Arkansas | 18 | $136.45 | $136.45 | $136.45 | $136.45 | $136.45 |
| California | 274 | $81.00 | $136.45 | $136.45 | $136.45 | $274.78 |
| Colorado | 52 | $81.00 | $136.45 | $136.45 | $136.45 | $214.30 |
| Connecticut | 69 | $81.00 | $136.45 | $136.45 | $136.45 | $287.66 |
| Delaware | 92 | $81.00 | $136.45 | $136.45 | $136.45 | $239.70 |
| District of Columbia | 35 | $81.00 | $136.45 | $136.45 | $136.45 | $136.45 |
| Florida | 352 | $81.00 | $136.45 | $136.45 | $136.45 | $344.24 |
| Georgia | 107 | $81.00 | $136.45 | $136.45 | $136.45 | $137.80 |
| Hawaii | 9 | $136.45 | $136.45 | $136.45 | $136.45 | $136.45 |
| Idaho | 11 | $81.00 | $136.45 | $136.45 | $136.45 | $194.40 |
| Illinois | 134 | $81.00 | $136.45 | $136.45 | $136.45 | $227.64 |
| Indiana | 42 | $81.00 | $136.45 | $136.45 | $136.45 | $227.64 |
| Iowa | 20 | $136.45 | $136.45 | $136.45 | $136.45 | $137.80 |
| Kansas | 16 | $81.00 | $136.45 | $136.45 | $136.45 | $136.45 |
| Kentucky | 40 | $81.00 | $136.45 | $136.45 | $136.45 | $330.71 |
| Louisiana | 18 | $81.00 | $136.45 | $136.45 | $136.45 | $195.60 |
| Maine | 32 | $81.00 | $136.45 | $136.45 | $136.45 | $274.78 |
| Maryland | 619 | $81.00 | $136.45 | $136.45 | $136.45 | $330.71 |
| Massachusetts | 108 | $81.00 | $136.45 | $136.45 | $136.45 | $214.30 |
| Michigan | 142 | $81.00 | $136.45 | $136.45 | $136.45 | $136.45 |
| Minnesota | 326 | $81.00 | $136.45 | $136.45 | $136.45 | $253.85 |
| Mississippi | 14 | $136.45 | $136.45 | $136.45 | $136.45 | $137.80 |
| Missouri | 63 | $90.72 | $136.45 | $136.45 | $136.45 | $136.45 |
| Montana | 10 | $81.00 | $136.45 | $136.45 | $136.45 | $227.64 |
| Nebraska | 8 | $90.72 | $136.45 | $136.45 | $136.45 | $136.45 |
| Nevada | 35 | $136.45 | $136.45 | $136.45 | $136.45 | $136.45 |
| New Hampshire | 29 | $136.45 | $136.45 | $136.45 | $136.45 | $136.45 |
| New Jersey | 310 | $81.00 | $136.45 | $136.45 | $136.45 | $274.78 |
| New Mexico | 20 | $81.00 | $136.45 | $136.45 | $136.45 | $136.45 |
| New York | 1,343 | $81.00 | $136.45 | $136.45 | $136.45 | $330.71 |
| North Carolina | 153 | $81.00 | $136.45 | $136.45 | $136.45 | $287.66 |
| North Dakota | 10 | $136.45 | $136.45 | $136.45 | $136.45 | $136.45 |
| Ohio | 1,548 | $81.00 | $136.45 | $136.45 | $136.45 | $287.66 |
| Oklahoma | 18 | $81.00 | $136.45 | $136.45 | $136.45 | $136.45 |
| Oregon | 36 | $81.00 | $136.45 | $136.45 | $136.45 | $136.45 |
| Pennsylvania | 26,673 | $81.00 | $136.45 | $136.45 | $136.45 | $492.17 |
| Puerto Rico | 5 | $136.45 | $136.45 | $136.45 | $136.45 | $136.45 |
| Rhode Island | 18 | $90.72 | $136.45 | $136.45 | $136.45 | $136.45 |
| South Carolina | 76 | $90.72 | $136.45 | $136.45 | $136.45 | $136.45 |
| South Dakota | 4 | $136.45 | $136.45 | $136.45 | $136.45 | $136.45 |
| Tennessee | 63 | $90.72 | $136.45 | $136.45 | $136.45 | $253.85 |
| Texas | 205 | $81.00 | $136.45 | $136.45 | $136.45 | $253.85 |
| Utah | 16 | $81.00 | $136.45 | $136.45 | $136.45 | $136.45 |
| Vermont | 6 | $81.00 | $136.45 | $136.45 | $136.45 | $136.45 |
| Virginia | 206 | $81.00 | $136.45 | $136.45 | $136.45 | $274.78 |
| Washington | 64 | $81.00 | $136.45 | $136.45 | $136.45 | $136.45 |
| West Virginia | 519 | $81.00 | $136.45 | $136.45 | $136.45 | $287.66 |
| Wisconsin | 46 | $90.72 | $136.45 | $136.45 | $136.45 | $244.57 |
| Wyoming | 3 | $136.45 | $136.45 | $136.45 | $136.45 | $136.45 |

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