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Observation Follow-Up Visit, High Complexity

South Carolina 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.

Professionalmedian $74 · 10th–90th $30$1820%20%40%10th90th$74$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
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$489.78
Medcost
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$30.20
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$102.33
Typical High
$181.97