go back

Missouri 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 $100–$2340%50%10th90th$209Professionalmedian $107 · 10th–90th $79–$4790%10%20%10th90th$107$50.0$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
$407.38 / $407.38 / $489.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $234.42
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $478.63 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $100.00 / $131.83