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Nevada 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 $123 · 10th–90th $87–$5620%20%10th90th$123Professionalmedian $115 · 10th–90th $62–$2570%5%10%10th90th$115$1.0$5.0$20.0$100.0$500.0

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
$87.10 / $123.03 / $562.34
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $114.82 / $257.04
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $81.28 / $158.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $102.33 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $112.20 / $177.83
Hometown Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.63 / $87.10 / $128.82
Hometown Health
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
Hometown Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.63 / $0.63 / $109.65
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $380.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $104.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $100.00 / $165.96