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Observation Care Admission, Straightforward

Pennsylvania 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?

$69.18

Typical physician fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $69.18 for this service. Most negotiated rates run $60.26 to $85.11.

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 $76 · 10th to 90th $76 to $76Professionalmedian $69 · 10th to 90th $60 to $117
$100facility $76professional $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
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$63.10
Typical High
$117.49
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$77.62
Typical High
$77.62
United
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$95.50
Typical High
$120.23

Where Pennsylvania sits

The same service costs 16.6 times more in North Carolina than in South Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 47th of 49

$69.18

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.