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Connecticut rates for HCPCS 99221

Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.

Facilitymedian $178 · 10th–90th $102–$9,1200%20%10th90th$178Professionalmedian $112 · 10th–90th $66–$2000%10%10th90th$112$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $177.83 / $218.78
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$229.09 / $229.09 / $10,964.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $112.20 / $199.53
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,025.60 / $7,244.36 / $10,000.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $117.49 / $173.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $120.23 / $194.98
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $104.71 / $147.91
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $144.54 / $177.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $128.82 / $213.80