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Montana rates for HCPCS 99222

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 moderate level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.

Facilitymedian $251 · 10th–90th $191–$3,1620%20%10th90th$251Professionalmedian $158 · 10th–90th $110–$3470%20%10th90th$158$10.0$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
$891.25 / $2,454.71 / $3,162.28
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$676.08 / $1,905.46 / $4,073.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $158.49 / $398.11
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64,565.42 / $77,624.71 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $169.82 / $234.42
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $223.87 / $251.19
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $223.87 / $251.19
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $181.97 / $316.23
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $181.97 / $331.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $218.78 / $251.19