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Washington, DC 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 $162 · 10th–90th $59–$2290%10%10th90th$162Professionalmedian $91 · 10th–90th $63–$1820%10%10th90th$91$20.0$50.0$100.0$200.0$500.0

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
$58.88 / $162.18 / $229.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $91.20 / $181.97
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $85.11 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $100.00 / $186.21
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $181.97 / $199.53
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $77.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $107.15 / $199.53