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Procedure price report · Consultation, evaluation, and preventative care

Hospital specialist consultation, moderate-complexity visit

CPT 99254the 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 moderate complexity and a longer period of physician time and decision-making.

Hospitals typically charge $273 cash for this outpatient procedure — the median across 699 hospitals that filed a usable cash price; the average of the middle 60% is $276. Most fall between $154 and $432 (20th–80th percentile).

Hospitals
699
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 699 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
$113$176$273$394$539

The most expensive tenth of hospitals charges at least 4.8× what the cheapest tenth charges ($113 vs $539).

How the prices are spread

$87 – $107: 22 hospitals$87$107 – $130: 38 hospitals$130 – $159: 56 hospitals$130$159 – $194: 47 hospitals$194 – $236: 85 hospitals$194$236 – $288: 94 hospitals$288 – $352: 112 hospitals$288$352 – $429: 72 hospitals$429 – $524: 65 hospitals$429$524 – $639: 41 hospitals$524median $273price bands are equal on a log scale
Hospitals per price band (632 of 699 — the bands cover the 5th to 95th percentile)
FromToHospitals
$87$10722
$107$13038
$130$15956
$159$19447
$194$23685
$236$28894
$288$352112
$352$42972
$429$52465
$524$63941

By state

The median cash price in each state, against the national median of $273.

Alaska: median $585 across 11 hospitalsAK$585Maine: median $284 across 21 hospitalsME$284Vermont: median $318 across 11 hospitalsVT$318New Hampshire: 8 hospitals filed a usable price — fewer than 10, so no figureNHWashington: median $288 across 21 hospitalsWA$288Idaho: 4 hospitals filed a usable price — fewer than 10, so no figureIDMontana: median $298 across 14 hospitalsMT$298North Dakota: 4 hospitals filed a usable price — fewer than 10, so no figureNDMinnesota: median $335 across 43 hospitalsMN$335Illinois: median $306 across 40 hospitalsIL$306Wisconsin: median $439 across 36 hospitalsWI$439Michigan: median $217 across 39 hospitalsMI$217New York: median $247 across 28 hospitalsNY$247Massachusetts: 4 hospitals filed a usable price — fewer than 10, so no figureMAOregon: median $250 across 13 hospitalsOR$250Nevada: 4 hospitals filed a usable price — fewer than 10, so no figureNVWyoming: 6 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 $303 across 42 hospitalsIA$303Indiana: median $156 across 27 hospitalsIN$156Ohio: median $310 across 23 hospitalsOH$310Pennsylvania: median $156 across 28 hospitalsPA$156New 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 $215 across 23 hospitalsCA$215Utah: 2 hospitals filed a usable price — fewer than 10, so no figureUTColorado: median $269 across 18 hospitalsCO$269Nebraska: median $309 across 14 hospitalsNE$309Missouri: median $260 across 23 hospitalsMO$260Kentucky: median $181 across 16 hospitalsKY$181West Virginia: median $179 across 15 hospitalsWV$179Virginia: 6 hospitals filed a usable price — fewer than 10, so no figureVAMaryland: 3 hospitals filed a usable price — fewer than 10, so no figureMDDelaware: no hospital in the corpus filed a usable priceDEArizona: 5 hospitals filed a usable price — fewer than 10, so no figureAZNew Mexico: 1 hospital filed a usable price — fewer than 10, so no figureNMKansas: median $230 across 21 hospitalsKS$230Arkansas: 5 hospitals filed a usable price — fewer than 10, so no figureARTennessee: median $123 across 11 hospitalsTN$123North Carolina: 6 hospitals filed a usable price — fewer than 10, so no figureNCSouth Carolina: 6 hospitals filed a usable price — fewer than 10, so no figureSCOklahoma: median $141 across 17 hospitalsOK$141Louisiana: 4 hospitals filed a usable price — fewer than 10, so no figureLAMississippi: 8 hospitals filed a usable price — fewer than 10, so no figureMSAlabama: 6 hospitals filed a usable price — fewer than 10, so no figureALGeorgia: median $212 across 15 hospitalsGA$212Hawaii: 8 hospitals filed a usable price — fewer than 10, so no figureHITexas: median $239 across 13 hospitalsTX$239Florida: median $260 across 13 hospitalsFL$260
Cash price by state, most expensive first. National median $273. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
Alaska AK11$585+115%$386 – $807
Wisconsin WI36$439+61%$299 – $634
Minnesota MN43$335+23%$232 – $635
Vermont VT11$318+17%$216 – $506
Ohio OH23$310+13%$146 – $586
Nebraska NE14$309+13%$280 – $537
Illinois IL40$306+12%$206 – $469
Iowa IA42$303+11%$242 – $377
Montana MT14$298+9%$179 – $447
Washington WA21$288+6%$250 – $423
Maine ME21$284+4%$119 – $447
Colorado CO18$269−1%$198 – $412
Missouri MO23$260−5%$159 – $293
Florida FL13$260−5%$60 – $778
Oregon OR13$250−9%$250 – $341
New York NY28$247−9%$143 – $389
Texas TX13$239−12%$115 – $449
Kansas KS21$230−16%$173 – $303
Michigan MI39$217−20%$171 – $293
California CA23$215−21%$75 – $344
Georgia GA15$212−22%$155 – $344
Kentucky KY16$181−34%$135 – $202
West Virginia WV15$179−34%$142 – $251
Pennsylvania PA28$156−43%$94 – $939
Indiana IN27$156−43%$113 – $373
Oklahoma OK17$141−48%$141 – $240
Tennessee TN11$123−55%$92 – $208
Hawaii HI8not enough hospitals filed a usable price
Mississippi MS8not enough hospitals filed a usable price
New Hampshire NH8not enough hospitals filed a usable price
Alabama AL6not enough hospitals filed a usable price
Connecticut CT6not enough hospitals filed a usable price
North Carolina NC6not enough hospitals filed a usable price
South Carolina SC6not enough hospitals filed a usable price
Virginia VA6not enough hospitals filed a usable price
Wyoming WY6not enough hospitals filed a usable price
Arkansas AR5not enough hospitals filed a usable price
Arizona AZ5not enough hospitals filed a usable price
Idaho ID4not enough hospitals filed a usable price
Louisiana LA4not enough hospitals filed a usable price
Massachusetts MA4not enough hospitals filed a usable price
North Dakota ND4not 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
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
New Mexico NM1not 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 $273.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care376$250$141 – $395
Children’s18fewer than 20 hospitals
Critical access304$299$179 – $439
Ownership
For-profit37$181$113 – $362
Government191$281$165 – $408
Non-profit470$276$154 – $439
System affiliation
Part of a system473$272$143 – $439
Independent226$276$169 – $408

Cash price vs list price

Median list price (chargemaster)$406
Median cash price$273
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

425 hospitals filed a usable inpatient cash price for this code. The median is $270 and the average of the middle 60% is $277; most fall between $150 and $435.

Cash price percentiles, inpatient, across 425 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
$115$172$270$402$515

The most expensive tenth of hospitals charges at least 4.5× what the cheapest tenth charges ($115 vs $515).

Of the 457 hospitals that filed this code inpatient, 425 gave a usable cash price; 2 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

699 of the 3,956 hospitals with a price file in our corpus (18%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 743 hospitals that filed this code at all gave us
Usable cash price — counted699
Cash price carrying a plausibility flag — shown on the compare tool, excluded here14
A number the filing itself marks as not a price (a placeholder, a ratio) — excluded0
An estimate rather than a filed cash price — excluded0
A list price only, no cash figure — excluded30
Hospitals that filed this code743

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 Mod Mdm 60 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, moderate-complexity visit (CPT 99254) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-99254-hospital-specialist-consultation-moderate-complexity-visit