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Virginia 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 $204 · 10th–90th $138–$3720%10%10th90th$204Professionalmedian $178 · 10th–90th $132–$3630%10%20%10th90th$178$50.0$200.0$1.0K$5.0K

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
$138.04 / $186.21 / $323.59
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $173.78 / $354.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $263.03 / $398.11
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $190.55 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $239.88 / $446.68
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $194.98 / $660.69
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $218.78 / $316.23
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $245.47 / $363.08
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $239.88 / $954.99
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $239.88 / $954.99
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $190.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $213.80 / $407.38