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South Carolina 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 $69 · 10th–90th $52–$1550%10%10th90th$69Professionalmedian $98 · 10th–90th $62–$2190%5%10%10th90th$98$20.0$50.0$100.0$200.0$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
$52.48 / $58.88 / $107.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $97.72 / $223.87
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $75.86 / $102.33
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $691.83 / $794.33
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $104.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $109.65 / $199.53
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $117.49
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $123.03 / $199.53
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $97.72 / $158.49