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Observation Follow-Up Visit, Moderate Complexity

Washington rates for HCPCS 99225

A follow-up visit by the doctor to a patient already being kept under observation in hospital. The doctor reviews how you have responded, checks results that have come back and adjusts the plan. This version covers a moderately involved review, where the picture is changing or several findings have to be weighed together.

Rates data updated July 2026.

How much does Observation Follow-Up Visit, Moderate Complexity cost?

$112

Typical negotiated rate. In Washington, July 2026.

Insurers have agreed to pay about $112 for this service. The price depends on where it is billed: about $120 from a physician practice, and about $112 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$120$70.79 to $155
FacilityA hospital or hospital-owned outpatient department$112$67.61 to $151

How much rates vary

Facilitymedian $112 · 10th to 90th $47 to $170Professionalmedian $120 · 10th to 90th $56 to $170
$50$100$200facility $112professional $120

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$162.18
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$112.20
Typical High
$173.78
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$120.23
Typical High
$169.82
Molina
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$117.49
Typical High
$138.04
United
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$50.12
Typical High
$70.79
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$87.10
Typical High
$109.65

Where Washington sits

The same service costs 11.2 times more in Tennessee than in South Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Washington· 18th of 49

$112

TN $339SC $30.20

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.