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New York 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 $162 · 10th–90th $102–$2690%20%10th90th$162Professionalmedian $141 · 10th–90th $85–$3240%20%10th90th$141$0.1$1.0$10.0$100.0$1.0K$10.0K

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
$120.23 / $162.18 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $138.04 / $323.59
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $120.23 / $186.21
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $112.20 / $302.00
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $199.53 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $190.55 / $467.74
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $131.83 / $302.00
Emblem Health
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$0.10 / $0.10 / $0.10
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $131.83 / $229.09
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $141.25 / $239.88
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $169.82 / $269.15
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $190.55 / $263.03
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $138.04 / $288.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $138.04 / $446.68
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $169.82 / $275.42
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $125.89 / $389.05
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $144.54 / $331.13