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Initial Hospital Care, Highest Complexity

Idaho rates for HCPCS 99223

This covers the first visit from a doctor or other provider after a patient is admitted to the hospital, for the most complex cases requiring a thorough history, exam, and high-level medical decision making. It reflects the most involved level of initial hospital evaluation, typically used for patients who are seriously ill or have multiple significant health problems.

Rates data updated July 2026.

How much does Initial Hospital Care, Highest Complexity cost?

$229

Typical negotiated rate. In Idaho, July 2026.

Insurers have agreed to pay about $229 for this service. The price depends on where it is billed: about $229 from a physician practice, and about $257 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$229$178 to $309
FacilityA hospital or hospital-owned outpatient department$257$229 to $398

How much rates vary

Facilitymedian $257 · 10th to 90th $148 to $891Professionalmedian $229 · 10th to 90th $158 to $513
$50$100$200$500$1Kfacility $257professional $229

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$245.47
Typical High
$245.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$229.09
Typical High
$524.81
BCBS
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$707.95
Typical High
$1,412.54
BCBS
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$331.13
Typical High
$354.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$309.03
Typical High
$407.38
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$275.42
Typical High
$416.87
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$288.40
Typical High
$398.11
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$147.91
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$269.15
Typical High
$309.03
Select Health
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$154.88
Typical High
$1,348.96
Select Health
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$316.23
United
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
United
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$257.04
Typical High
$467.74

Where Idaho sits

The same service costs 1.6 times more in Minnesota than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Idaho· 5th of 51

$229

MN $245DC $155

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.