go back

Wisconsin 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 $166 · 10th–90th $93–$6610%10%10th90th$166Professionalmedian $145 · 10th–90th $98–$4370%10%10th90th$145$1.0$5.0$20.0$100.0$500.0

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
$83.18 / $239.88 / $660.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $134.90 / $436.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $199.53 / $371.54
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $181.97 / $251.19
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $295.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $398.11 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $323.59 / $426.58
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $141.25 / $263.03
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $316.23 / $380.19
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $141.25 / $269.15
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $295.12 / $831.76
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $177.83
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $269.15
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $257.04 / $478.63
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $281.84 / $398.11
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $831.76 / $831.76
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $660.69 / $831.76
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $229.09
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $380.19 / $524.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $162.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $323.59 / $436.52