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Initial Hospital Or Observation Visit, Lower Complexity

Maryland rates for HCPCS 99221

The first evaluation by a doctor or other qualified clinician after a person is admitted to hospital as an inpatient or placed under observation care, at the level used for more straightforward cases. It covers taking the history, examining the patient, reviewing results and setting out the initial plan of care for that day.

Rates data updated July 2026.

How much does Initial Hospital Or Observation Visit, Lower Complexity cost?

$110

Typical physician fee. In Maryland, July 2026.

Insurers have agreed to pay about $110 for this service. Most negotiated rates run $79.43 to $178.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $81 · 10th to 90th $71 to $132Professionalmedian $110 · 10th to 90th $68 to $282
$20$50$100$200$500facility $81professional $110

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$81.28
Typical High
$131.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$109.65
Typical High
$302.00
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$85.11
Typical High
$134.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$128.82
Typical High
$199.53
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$89.13
Typical High
$165.96
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$120.23
Typical High
$190.55
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$100.00
Typical High
$125.89

Where Maryland sits

The same service costs 2.1 times more in Minnesota than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Maryland· 22nd of 51

$110

MN $155DC $74.13

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.