go back

Observation Follow-Up Visit, High Complexity

Ohio 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 October 2026.

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

$107

Typical physician fee. In Ohio, October 2026.

Insurers have agreed to pay about $107 for this service. Most negotiated rates run $97.72 to $110.

Few insurers publish rates for this combination, so treat this figure as a rough guide.

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 3 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $107 · 10th to 90th $85 to $123
$100professional $107

Distribution of negotiated rates across all payers (price axis is log-scale). 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
None
Typical Low
$85.11
Median
$107.15
Typical High
$123.03
Medical Mutual of Ohio
Setting
Professional
Modifier
None
Typical Low
$102.33
Median
$109.65
Typical High
$109.65
United
Setting
Professional
Modifier
None
Typical Low
$89.13
Median
$89.13
Typical High
$97.72

Where Ohio sits

The same service costs 15.8 times more in Massachusetts than in Idaho. 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.

Ohio· 30th of 37

$107

MA $479ID $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.