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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.

Facilitymedian $100 · 10th–90th $74$8710%50%10th90th$100Professionalmedian $174 · 10th–90th $87$4680%10%20%10th90th$174$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
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