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Oregon 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 $339 · 10th–90th $219–$4790%10%20%10th90th$339Professionalmedian $219 · 10th–90th $145–$5500%10%10th90th$219$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
$239.88 / $398.11 / $588.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $218.78 / $575.44
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
$213.80 / $371.54 / $549.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $331.13 / $407.38
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $295.12 / $478.63
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $281.84 / $512.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $338.84 / $380.19
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $269.15 / $446.68
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $380.19 / $501.19
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $426.58 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $338.84 / $537.03