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Oregon 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 $166 · 10th–90th $110–$3470%10%20%10th90th$166Professionalmedian $138 · 10th–90th $69–$3160%5%10%10th90th$138$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
$120.23 / $190.55 / $3,388.44
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $4,168.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $131.83 / $331.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $186.21 / $269.15
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $158.49 / $190.55
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $151.36 / $234.42
Moda Health
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $4,168.69
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $158.49 / $263.03
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $158.49 / $194.98
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $138.04 / $234.42
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $186.21 / $245.47
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $204.17 / $263.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $173.78 / $269.15