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Iowa 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 $129 · 10th–90th $62–$30,9030%10%20%10th90th$129Professionalmedian $107 · 10th–90th $62–$2290%10%10th90th$107$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$53.70 / $112.20 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $104.71 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $154.88 / $194.98
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $144.54 / $245.47
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $131.83 / $194.98
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $162.18 / $616.60
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $162.18 / $213.80
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $204.17 / $204.17
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $28,183.83 / $40,738.03
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $138.04 / $177.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $117.49 / $223.87
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $125.89 / $138.04