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Iowa rates for HCPCS 99219

Initial observation care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission to outpatient hospital "observation status" are of moderate severity. Typically, 50 minutes are spent at the bedside and on the patient's hospital floor or unit.

Facilitymedian $158 · 10th–90th $158–$4680%20%40%90th$158Professionalmedian $275 · 10th–90th $145–$6310%10%20%10th90th$275$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $288.40
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $467.74
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $630.96 / $630.96
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $275.42
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $251.19 / $323.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $87.10 / $208.93