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Observation Care Admission, Straightforward

Kentucky rates for HCPCS 99218

The doctor's first full assessment when you are placed under observation in hospital — kept in a bed for monitoring and testing without being formally admitted. It covers the history, examination and plan on the day observation starts, for a problem that is comparatively uncomplicated.

Rates data updated July 2026.

How much does Observation Care Admission, Straightforward cost?

$87.10

Typical physician fee. In Kentucky, July 2026.

Insurers have agreed to pay about $87.10 for this service. Most negotiated rates run $64.57 to $38,905.

Few insurers publish rates for this combination, so treat this figure as a rough guide.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $38,905 · 10th to 90th $38,905 to $38,905Professionalmedian $69 · 10th to 90th $51 to $48,978
$100.0$1.0K$10.0Kfacility $38,905professional $69

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
CareSource
Setting
Facility
Modifier
Global
Typical Low
$38,904.51
Median
$38,904.51
Typical High
$38,904.51
CareSource
Setting
Professional
Modifier
Global
Typical Low
$46,773.51
Median
$48,977.88
Typical High
$51,286.14
Molina
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$61.66
Typical High
$69.18
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$87.10

Where Kentucky sits

The same service costs 16.6 times more in North Carolina than in South Carolina. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Kentucky $87.10 · 38th of 49
NC $501SC $30.20

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.