go back

Observation Follow-Up Visit, High Complexity

Illinois rates for HCPCS 99226

A follow-up visit by the doctor to a patient under observation in hospital whose condition is unstable or has worsened. It covers a detailed reassessment, a full review of new findings, and complex decisions about changing treatment or moving to a full admission.

Rates data updated July 2026.

How much rates vary

Facilitymedian $100 · 10th to 90th $74 to $871Professionalmedian $174 · 10th to 90th $87 to $468
$100$200$500facility $100professional $174

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$407.38
Typical High
$489.78
United
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$100.00
Typical High
$870.96
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$89.13
Typical High
$173.78