search again

Nationwide rates for HCPCS 99223

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 high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.

Facilitymedian $219 · 10th–90th $151–$5620%20%10th90th$219Professionalmedian $195 · 10th–90th $132–$4570%20%10th90th$195$0.1$1.0$10.0$100.0$1.0K$10.0K$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
$134.90 / $194.98 / $380.19
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$151.36 / $630.96 / $17,378.01
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $194.98 / $457.09
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $251.19 / $630.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $213.80 / $389.05
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $549.54 / $1,513.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $263.03 / $501.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $169.82 / $234.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $229.09 / $467.74

See more rates by state

Want provider-level rates data? We offer custom data extracts for a reasonable fee. To learn more, please email us.