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Missouri 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 $174 · 10th–90th $102–$3240%20%10th90th$174Professionalmedian $182 · 10th–90th $123–$3720%20%10th90th$182$1.0$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
$102.33 / $162.18 / $323.59
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $177.83 / $371.54
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $165.96 / $245.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $199.53 / $323.59
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $181.97 / $275.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $239.88 / $398.11
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $223.87 / $549.54
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $229.09 / $1,202.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $165.96 / $234.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $204.17 / $309.03