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Michigan 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 $85 · 10th–90th $72–$980%50%10th90th$85Professionalmedian $100 · 10th–90th $65–$2290%10%10th90th$100$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
$64.57 / $85.11 / $85.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $100.00 / $229.09
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $91.20 / $144.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $104.71 / $120.23
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $95.50 / $114.82
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $100.00 / $144.54
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $107.15 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $97.72 / $190.55
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $85.11 / $269.15
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $95.50 / $186.21
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $95.50 / $194.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $89.13 / $117.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $109.65 / $223.87