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Utah 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–$2090%20%10th90th$178Professionalmedian $204 · 10th–90th $126–$5010%10%10th90th$204$50.0$100.0$200.0$500.0$1.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $177.83 / $208.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $204.17 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $281.84 / $562.34
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $354.81
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $229.09 / $436.52
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $263.03 / $831.76
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $239.88 / $371.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $239.88 / $338.84