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Observation Care Admission, Moderate Complexity

Kentucky 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?

$166

Typical physician fee. In Kentucky, July 2026.

Insurers have agreed to pay about $166 for this service. Most negotiated rates run $89.13 to $38,905.

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.

How much rates vary

Facilitymedian $38,905 · 10th to 90th $38,905 to $38,905Professionalmedian $107 · 10th to 90th $85 to $48,978
$100$500$2K$10K$50Kfacility $38,905professional $107

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
CareSource
Setting
Facility
Modifier
Global
Typical Low
$38,904.51
Median
$38,904.51
Typical High
$38,904.51
CareSource
Setting
Professional
Modifier
Global
Typical Low
$46,773.51
Median
$48,977.88
Typical High
$51,286.14
Molina
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$102.33
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$89.13
Typical High
$208.93

Where Kentucky 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.

Kentucky· 28th of 50

$166

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.