go back

Observation Care Admission, Moderate Complexity

Illinois rates for HCPCS 99219

The doctor's first full assessment when you are placed under observation in hospital for monitoring and testing. It covers a more detailed history and examination and a moderately involved plan, for a problem that is more complicated than a routine one but not immediately dangerous.

Rates data updated July 2026.

How much does Observation Care Admission, Moderate Complexity cost?

$363

Typical facility fee. In Illinois, July 2026.

Insurers have agreed to pay about $363 for this service. Most negotiated rates run $240 to $676.

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 $372 · 10th to 90th $214 to $1,318Professionalmedian $209 · 10th to 90th $85 to $603
$100$200$500$1K$2Kfacility $372professional $209

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
BCBS
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$371.54
Typical High
$1,318.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$537.03
Typical High
$645.65
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$131.83
Typical High
$870.96
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$165.96
Typical High
$245.47

Where Illinois sits

The same service costs 20.9 times more in Massachusetts 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.

Illinois· 12th of 50

$363

MA $631SC $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.