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Utah 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 $112 · 10th–90th $100–$1320%20%10th90th$112Professionalmedian $102 · 10th–90th $58–$2340%10%10th90th$102$20.0$50.0$100.0$200.0

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
$100.00 / $112.20 / $131.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $102.33 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $141.25 / $269.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $177.83
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $114.82 / $218.78
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $123.03 / $407.38
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $114.82 / $173.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $114.82 / $169.82