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Virginia 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 $135 · 10th–90th $100–$3550%10%10th90th$135Professionalmedian $129 · 10th–90th $95–$2510%10%10th90th$129$20.0$100.0$500.0$2.0K$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
$91.20 / $114.82 / $467.74
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $125.89 / $245.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $181.97 / $269.15
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $131.83 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $165.96 / $302.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $147.91 / $446.68
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $154.88 / $229.09
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $169.82 / $251.19
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $162.18 / $645.65
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $162.18 / $645.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $141.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $154.88 / $275.42