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Procedure price report · Consultation, evaluation, and preventative care

Hospital specialist consultation, low-complexity visit

CPT 99253the billing code this page is about

A first consultation by a specialist for a patient who is admitted or under observation, at the level involving a problem of low complexity and a moderate amount of physician time and decision-making.

Hospitals typically charge $196 cash for this outpatient procedure — the median across 747 hospitals that filed a usable cash price; the average of the middle 60% is $199. Most fall between $110 and $308 (20th–80th percentile).

Hospitals
747
States
49
Filings dated
Dec 2023 – Sep 2026
Computed
September 25, 2026
Prices checked
through September 24, 2026

Median: half of hospitals filed less, half more — and it is a price some hospital actually filed. Average of the middle 60%: the mean of the prices between the 20th and 80th percentiles. We never publish the plain average, the lowest or the highest price: the extremes in hospital price files are chargemaster artefacts, not prices anyone pays.

What hospitals charge, from cheapest to most expensive

Cash price percentiles, outpatient, across 747 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$80$124$196$287$384

The most expensive tenth of hospitals charges at least 4.8× what the cheapest tenth charges ($80 vs $384).

How the prices are spread

$67 – $81: 48 hospitals$67$81 – $99: 30 hospitals$99 – $120: 58 hospitals$99$120 – $146: 66 hospitals$146 – $178: 90 hospitals$146$178 – $216: 108 hospitals$216 – $263: 88 hospitals$216$263 – $320: 83 hospitals$320 – $390: 67 hospitals$320$390 – $474: 35 hospitals$390median $196price bands are equal on a log scale
Hospitals per price band (673 of 747 — the bands cover the 5th to 95th percentile)
FromToHospitals
$67$8148
$81$9930
$99$12058
$120$14666
$146$17890
$178$216108
$216$26388
$263$32083
$320$39067
$390$47435

By state

The median cash price in each state, against the national median of $196.

Alaska: median $388 across 11 hospitalsAK$388Maine: median $176 across 21 hospitalsME$176Vermont: median $200 across 12 hospitalsVT$200New Hampshire: 8 hospitals filed a usable price — fewer than 10, so no figureNHWashington: median $212 across 21 hospitalsWA$212Idaho: 4 hospitals filed a usable price — fewer than 10, so no figureIDMontana: median $235 across 14 hospitalsMT$235North Dakota: 5 hospitals filed a usable price — fewer than 10, so no figureNDMinnesota: median $262 across 46 hospitalsMN$262Illinois: median $239 across 41 hospitalsIL$239Wisconsin: median $349 across 36 hospitalsWI$349Michigan: median $162 across 41 hospitalsMI$162New York: median $170 across 28 hospitalsNY$170Massachusetts: 5 hospitals filed a usable price — fewer than 10, so no figureMAOregon: median $181 across 12 hospitalsOR$181Nevada: 4 hospitals filed a usable price — fewer than 10, so no figureNVWyoming: 8 hospitals filed a usable price — fewer than 10, so no figureWYSouth Dakota: 4 hospitals filed a usable price — fewer than 10, so no figureSDIowa: median $209 across 46 hospitalsIA$209Indiana: median $127 across 25 hospitalsIN$127Ohio: median $176 across 22 hospitalsOH$176Pennsylvania: median $90 across 22 hospitalsPA$90New Jersey: 1 hospital filed a usable price — fewer than 10, so no figureNJConnecticut: 6 hospitals filed a usable price — fewer than 10, so no figureCTRhode Island: 2 hospitals filed a usable price — fewer than 10, so no figureRICalifornia: median $137 across 23 hospitalsCA$137Utah: 2 hospitals filed a usable price — fewer than 10, so no figureUTColorado: median $210 across 16 hospitalsCO$210Nebraska: median $210 across 14 hospitalsNE$210Missouri: median $171 across 23 hospitalsMO$171Kentucky: median $110 across 17 hospitalsKY$110West Virginia: median $111 across 15 hospitalsWV$111Virginia: median $71 across 12 hospitalsVA$71Maryland: 3 hospitals filed a usable price — fewer than 10, so no figureMDDelaware: no hospital in the corpus filed a usable priceDEArizona: 4 hospitals filed a usable price — fewer than 10, so no figureAZNew Mexico: 2 hospitals filed a usable price — fewer than 10, so no figureNMKansas: median $177 across 26 hospitalsKS$177Arkansas: 6 hospitals filed a usable price — fewer than 10, so no figureARTennessee: median $72 across 16 hospitalsTN$72North Carolina: 7 hospitals filed a usable price — fewer than 10, so no figureNCSouth Carolina: 7 hospitals filed a usable price — fewer than 10, so no figureSCOklahoma: median $124 across 16 hospitalsOK$124Louisiana: 5 hospitals filed a usable price — fewer than 10, so no figureLAMississippi: median $138 across 14 hospitalsMS$138Alabama: 8 hospitals filed a usable price — fewer than 10, so no figureALGeorgia: median $123 across 19 hospitalsGA$123Hawaii: 8 hospitals filed a usable price — fewer than 10, so no figureHITexas: median $295 across 25 hospitalsTX$295Florida: median $279 across 14 hospitalsFL$279
Cash price by state, most expensive first. National median $196. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
Alaska AK11$388+98%$275 – $580
Wisconsin WI36$349+78%$215 – $481
Texas TX25$295+50%$114 – $295
Florida FL14$279+42%$141 – $572
Minnesota MN46$262+33%$181 – $421
Illinois IL41$239+22%$144 – $383
Montana MT14$235+20%$122 – $340
Washington WA21$212+8%$169 – $256
Colorado CO16$210+7%$192 – $304
Nebraska NE14$210+7%$190 – $293
Iowa IA46$209+7%$165 – $263
Vermont VT12$200+2%$149 – $351
Oregon OR12$181−8%$181 – $235
Kansas KS26$177−10%$119 – $229
Maine ME21$176−10%$90 – $361
Ohio OH22$176−10%$120 – $365
Missouri MO23$171−13%$110 – $254
New York NY28$170−13%$100 – $281
Michigan MI41$162−17%$141 – $289
Mississippi MS14$138−30%$98 – $155
California CA23$137−30%$56 – $274
Indiana IN25$127−35%$81 – $274
Oklahoma OK16$124−37%$124 – $226
Georgia GA19$123−38%$71 – $239
West Virginia WV15$111−43%$103 – $197
Kentucky KY17$110−44%$97 – $169
Pennsylvania PA22$90−54%$66 – $200
Tennessee TN16$72−63%$72 – $85
Virginia VA12$71−64%$55 – $72
Alabama AL8not enough hospitals filed a usable price
Hawaii HI8not enough hospitals filed a usable price
New Hampshire NH8not enough hospitals filed a usable price
Wyoming WY8not enough hospitals filed a usable price
North Carolina NC7not enough hospitals filed a usable price
South Carolina SC7not enough hospitals filed a usable price
Arkansas AR6not enough hospitals filed a usable price
Connecticut CT6not enough hospitals filed a usable price
Louisiana LA5not enough hospitals filed a usable price
Massachusetts MA5not enough hospitals filed a usable price
North Dakota ND5not enough hospitals filed a usable price
Arizona AZ4not enough hospitals filed a usable price
Idaho ID4not enough hospitals filed a usable price
Nevada NV4not enough hospitals filed a usable price
South Dakota SD4not enough hospitals filed a usable price
Maryland MD3not enough hospitals filed a usable price
New Mexico NM2not enough hospitals filed a usable price
Rhode Island RI2not enough hospitals filed a usable price
Utah UT2not enough hospitals filed a usable price
New Jersey NJ1not enough hospitals filed a usable price

Hospitals like yours

The same distribution cut by the kind of hospital. Hospital type and ownership come from CMS; a hospital counts as part of a system when its price file is shared with at least one other hospital under the same brand. The national median is $196.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care394$174$97 – $293
Children’s18fewer than 20 hospitals
Critical access334$214$134 – $337
Ownership
For-profit37$119$80 – $277
Government205$206$122 – $295
Non-profit504$198$111 – $324
System affiliation
Part of a system516$197$106 – $315
Independent231$195$124 – $304

Cash price vs list price

Median list price (chargemaster)$294
Median cash price$196
Cash as a share of list, median hospital70%

At the typical hospital, asking for the cash price cuts the list price by about 30%. The share is the median of each hospital’s own cash ÷ list ratio, over hospitals that filed both — not the ratio of the two medians above.

The same procedure, inpatient

453 hospitals filed a usable inpatient cash price for this code. The median is $195 and the average of the middle 60% is $198; most fall between $110 and $304.

Cash price percentiles, inpatient, across 453 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$81$124$195$290$359

The most expensive tenth of hospitals charges at least 4.4× what the cheapest tenth charges ($81 vs $359).

Of the 484 hospitals that filed this code inpatient, 453 gave a usable cash price; 1 carried a plausibility flag, 0 filed a number their own filing marks as not a price, 0 gave an estimate, and 30 a list price only.

How complete is this

747 of the 3,956 hospitals with a price file in our corpus (19%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 803 hospitals that filed this code at all gave us
Usable cash price — counted747
Cash price carrying a plausibility flag — shown on the compare tool, excluded here13
A number the filing itself marks as not a price (a placeholder, a ratio) — excluded0
An estimate rather than a filed cash price — excluded1
A list price only, no cash figure — excluded42
Hospitals that filed this code803

Sections not shown for this setting

  • Against Medicare: Medicare has no separately payable national outpatient (OPPS) rate for this code, so there is nothing honest to compare against.
  • Since our last snapshot: there is no earlier snapshot at least 90 days older than this one yet.

We last checked these hospitals’ price files for changes between September 4, 2026 and September 24, 2026; the figures were computed September 25, 2026 from filings loaded through September 24, 2026. The percentiles and averages use only the “counted” row.

Related procedures

Part of the Consultation, evaluation, and preventative care family.

Hospitals file this code under descriptions such as IP/Obs Consltj New/Est Pt Low Mdm 45 Minutes.

Method

Source
The machine-readable price files every U.S. hospital is required by CMS to publish, parsed per hospital. Nothing is surveyed, sampled or modelled.
What counts
One cash (self-pay) price per hospital for this code and setting. A hospital’s own filing can rule its number out — a placeholder, a “not applicable” note, a list price standing in for cash — and our plausibility checks can flag a price far below what every other hospital files. Both kinds are disclosed above and excluded from the statistics; on the compare tool a flagged price is still shown.
Statistics
Percentiles are discrete: each is a price some hospital filed. The average is the mean of the prices between the 20th and 80th percentiles. We never publish the plain mean, the minimum or the maximum. A state needs 10 hospitals and a segment 20 to show a figure; otherwise the row shows its count and no number. Medicare is the national unadjusted OPPS rate where one exists.
Names
Procedure names on these pages are our own plain-language titles, not the AMA’s copyrighted CPT descriptors. The code is the identity.

The full rules — sources, statistics, thresholds, limitations — are on the methodology page.

Download this page’s figures: JSON · CSV. Aggregates only — the per-hospital prices are on the compare tool.

Cite: HospitalRates.com, “Hospital specialist consultation, low-complexity visit (CPT 99253) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-99253-hospital-specialist-consultation-low-complexity-visit