go back

Observation Care Admission, Moderate Complexity

Virginia 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?

$209

Typical physician fee. In Virginia, July 2026.

Insurers have agreed to pay about $209 for this service. Most negotiated rates run $138 to $501.

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 $525 · 10th to 90th $525 to $891Professionalmedian $170 · 10th to 90th $87 to $501
$100$200$500$1Kfacility $525professional $170

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
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$229.09
Typical High
$501.19
Medcost
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$154.88
Typical High
$223.87
United
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$524.81
Typical High
$891.25
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$120.23
Typical High
$281.84

Where Virginia 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.

Virginia· 22nd of 50

$209

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.