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Indiana 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 $117 · 10th–90th $65–$6,0260%10%10th90th$117Professionalmedian $98 · 10th–90th $59–$2040%10%10th90th$98$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
$58.88 / $112.20 / $7,762.47
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$91.20 / $123.03 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $95.50 / $204.17
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $89.13 / $112.20
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $190.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $97.72 / $151.36
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $100.00 / $125.89
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $97.72 / $123.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $100.00 / $173.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $89.13 / $91.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $97.72 / $141.25