go back

Observation Care Admission, Straightforward

Massachusetts 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?

$501

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $501 for this service. The price depends on where it is billed: about $501 from a physician practice, and about $603 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$501$501 to $501
FacilityA hospital or hospital-owned outpatient department$603$200 to $603

How much rates vary

Facilitymedian $603 · 10th to 90th $200 to $1,000Professionalmedian $501 · 10th to 90th $501 to $501
$100.0$200.0$500.0$1.0Kfacility $603professional $501

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
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$602.56
Typical High
$602.56
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$501.19
Median
$501.19
Typical High
$501.19
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$602.56
Typical High
$602.56
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$501.19
Median
$501.19
Typical High
$501.19
United
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$1,000.00
United
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$95.50
Typical High
$147.91

Where Massachusetts 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.

Massachusetts $501 · 4th 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.