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Observation Care Admission, Straightforward

Washington 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?

$155

Typical negotiated rate. In Washington, July 2026.

Insurers have agreed to pay about $155 for this service. The price depends on where it is billed: about $155 from a physician practice, and about $148 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 5 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$155$87.10 to $209
FacilityA hospital or hospital-owned outpatient department$148$83.18 to $200

How much rates vary

Facilitymedian $148 · 10th to 90th $55 to $234Professionalmedian $155 · 10th to 90th $55 to $234
$100$200facility $148professional $155

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$218.78
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$147.91
Typical High
$239.88
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$154.88
Typical High
$234.42
Molina
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$181.97
Typical High
$190.55
United
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$97.72
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$87.10
Typical High
$186.21

Where Washington 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.

Washington· 21st of 49

$155

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.