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Idaho 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 $151 · 10th–90th $93–$7940%10%10th90th$151Professionalmedian $141 · 10th–90th $74–$2750%5%10%10th90th$141$20.0$50.0$100.0$200.0$500.0$1.0K

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
$123.03 / $123.03 / $123.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $138.04 / $288.40
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $354.81 / $1,412.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $158.49 / $165.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $154.88 / $218.78
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $141.25 / $208.93
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $141.25 / $263.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $123.03 / $154.88
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $74.13 / $436.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $123.03 / $194.98