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Washington 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 $309 · 10th–90th $200–$4370%10%10th90th$309Professionalmedian $219 · 10th–90th $138–$5130%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
$199.53 / $269.15 / $467.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $218.78 / $524.81
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $257.04 / $331.13
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $338.84 / $467.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $338.84 / $512.86
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $346.74 / $436.52
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $354.81 / $457.09
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $338.84 / $380.19
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $257.04 / $257.04
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $363.08 / $501.19
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $338.84 / $467.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $165.96 / $331.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $263.03 / $478.63
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $181.97 / $316.23