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Vermont 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.

Professionalmedian $170 · 10th–90th $117–$3890%10%10th90th$170$100.0$200.0$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
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $169.82 / $389.05
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $251.19 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $257.04 / $407.38
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $269.15 / $389.05