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Michigan 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 $178 · 10th–90th $151–$2140%50%10th90th$178Professionalmedian $186 · 10th–90th $135–$4570%10%10th90th$186$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
$151.36 / $177.83 / $177.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $186.21 / $457.09
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $173.78 / $295.12
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $204.17 / $239.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $199.53 / $239.88
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $213.80 / $295.12
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $229.09 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $199.53 / $371.54
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $524.81
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $186.21 / $380.19
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $190.55 / $371.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $131.83 / $190.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $218.78 / $407.38