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Montana 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 $295 · 10th–90th $229–$4790%20%40%10th90th$295Professionalmedian $219 · 10th–90th $162–$4790%20%10th90th$219$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $218.78 / $478.63
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64,565.42 / $77,624.71 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $251.19 / $331.13
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $302.00 / $338.84
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $302.00 / $338.84
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $263.03 / $446.68
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $269.15 / $436.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $316.23 / $363.08