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Rhode Island 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 $178 · 10th–90th $100–$6,3100%20%10th90th$178Professionalmedian $100 · 10th–90th $59–$1660%10%10th90th$100$20.0$100.0$500.0$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
$100.00 / $100.00 / $6,309.57
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$1,174.90 / $1,819.70 / $1,819.70
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $100.00 / $165.96
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $194.98 / $239.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $93.33 / $154.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $144.54 / $204.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $104.71 / $239.88