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Maryland 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 $166 · 10th–90th $148–$1950%20%10th90th$166Professionalmedian $204 · 10th–90th $135–$4790%10%10th90th$204$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
$147.91 / $165.96 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $204.17 / $478.63
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $169.82 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $257.04 / $398.11
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $186.21 / $338.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $131.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $229.09 / $371.54
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $204.17 / $263.03