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Connecticut 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 $347 · 10th–90th $174–$6,1660%20%10th90th$347Professionalmedian $186 · 10th–90th $135–$3980%20%10th90th$186$1.0$5.0$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
$181.97 / $346.74 / $6,165.95
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$173.78 / $173.78 / $416.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $186.21 / $398.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,025.60 / $7,244.36 / $10,000.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $239.88 / $338.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $245.47 / $380.19
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $213.80 / $331.13
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $281.84 / $363.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $263.03 / $457.09