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West 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 $178 · 10th–90th $155–$2510%20%10th90th$178Professionalmedian $178 · 10th–90th $117–$3630%10%10th90th$178$10.0$20.0$50.0$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
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $162.18 / $208.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $177.83 / $363.08
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $213.80 / $295.12
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $346.74 / $389.05
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
$162.18 / $346.74 / $812.83
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $194.98 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $181.97 / $295.12