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Iowa rates for HCPCS 99226

Subsequent observation care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of high 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 unstable or has developed a significant complication or a significant new problem. Typically, 35 minutes are spent at the bedside and on the patient's hospital floor or unit.

Facilitymedian $209 · 10th–90th $209–$2090%50%100%$209Professionalmedian $214 · 10th–90th $145–$2450%20%40%10th90th$214$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $218.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $213.80 / $478.63
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $194.98 / $245.47
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $87.10 / $89.13