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 high 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 high severity. Typically, 70 minutes are spent at the bedside and on the patient's hospital floor or unit.
Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
BCBS
| Facility | $309.03 | $512.86 | $1,778.28 | |
Cigna
| Facility | $457.09 | $630.96 | $1,513.56 | |
Cigna
| Professional | $309.03 | $426.58 | $724.44 | |
United
| Facility | $141.25 | $177.83 | $181.97 | |
United
| Professional | $89.13 | $186.21 | $302.00 |
Want provider-level rates data? We offer custom data extracts for a reasonable fee. To learn more, please email us.