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Kansas 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 $81 · 10th–90th $46–$1550%10%10th90th$81Professionalmedian $98 · 10th–90th $62–$1450%10%10th90th$98$20.0$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$45.71 / $69.18 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $95.50 / $144.54
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $77.62 / $97.72
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $134.90 / $134.90
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $131.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $131.83 / $204.17
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $117.49 / $275.42
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $123.03 / $616.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $112.20 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $109.65 / $162.18