Tynbil: Know the *real* price for healthcare services

Texas rates for HCPCS 99225

Subsequent observation care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is responding inadequately to therapy or has developed a minor complication. Typically, 25 minutes are spent at the bedside and on the patient's hospital floor or unit.

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $346.74	Professional	$288.40	$288.40	$346.74
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility	$162.18	$162.18	$162.18
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Professional	$338.84	$338.84	$338.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $131.83 / $173.78	Professional	$67.61	$131.83	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $70.79 / $134.90	Professional	$58.88	$70.79	$134.90