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Observation Care Admission, Moderate Complexity

Washington 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 negotiated rate. In Washington, July 2026.

Insurers have agreed to pay about $209 for this service. The price depends on where it is billed: about $214 from a physician practice, and about $204 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$214$126 to $288
FacilityA hospital or hospital-owned outpatient department$204$120 to $269

How much rates vary

Facilitymedian $204 · 10th to 90th $91 to $324Professionalmedian $214 · 10th to 90th $91 to $316
$100$200facility $204professional $214

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
$239.88
Median
$239.88
Typical High
$302.00
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$204.17
Typical High
$331.13
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$213.80
Typical High
$316.23
Molina
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$257.04
Typical High
$257.04
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$131.83
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$165.96
Typical High
$245.47

Where Washington 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.

Washington· 23rd 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.