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Vermont 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.

Professionalmedian $102 · 10th–90th $56–$2190%10%10th90th$102$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
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $100.00 / $218.78
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $125.89 / $147.91
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $128.82 / $204.17
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $239.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $134.90 / $186.21