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Wisconsin rates for HCPCS 99232

Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.

Facilitymedian $87 · 10th–90th $58–$3470%10%20%10th90th$87Professionalmedian $81 · 10th–90th $58–$2290%10%10th90th$81$1.0$5.0$20.0$100.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $74.13 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $79.43 / $229.09
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $112.20 / $208.93
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $112.20 / $154.88
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $177.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $239.88 / $380.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $186.21 / $234.42
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $81.28 / $147.91
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $181.97 / $229.09
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $81.28 / $154.88
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $162.18 / $467.74
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $93.33
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $141.25
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $134.90 / $239.88
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $165.96 / $234.42
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $436.52 / $436.52
Quartz
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$14.79 / $43.65 / $43.65
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $354.81 / $457.09
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $229.09 / $275.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $83.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $165.96 / $234.42