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Indiana 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 $158 · 10th–90th $100–$2510%10%10th90th$158Professionalmedian $178 · 10th–90th $126–$3980%10%10th90th$178$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$93.33 / $134.90 / $208.93
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$269.15 / $3,890.45 / $3,890.45
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $177.83 / $398.11
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $177.83 / $239.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $398.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $204.17 / $316.23
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $208.93 / $263.03
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $204.17 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $204.17 / $346.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $190.55 / $190.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $199.53 / $295.12