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Montana 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 $145 · 10th–90th $112–$2290%50%10th90th$145Professionalmedian $123 · 10th–90th $69–$2510%10%20%10th90th$123$10.0$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
$83.18 / $151.36 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $123.03 / $251.19
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64,565.42 / $77,624.71 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $154.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $125.89 / $204.17
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $144.54 / $173.78
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $144.54 / $173.78
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $131.83 / $208.93
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $134.90 / $213.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $158.49 / $181.97