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Florida 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 $138 · 10th–90th $81–$9770%20%10th90th$138Professionalmedian $110 · 10th–90th $65–$2340%10%10th90th$110$10.0$50.0$200.0$1.0K$5.0K

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
$81.28 / $138.04 / $977.24
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$38.02 / $457.09 / $1,318.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $109.65 / $234.42
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $93.33 / $151.36
AvMed
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $67.61 / $85.11
AvMed
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $89.13 / $112.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $117.49 / $204.17
Florida Blue
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $58.88 / $95.50
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $107.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $81.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $102.33 / $199.53
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $75.86 / $102.33