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Ohio rates for HCPCS 99233

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 high level of medical decision making. When using total time on the date of the encounter for code selection, 50 minutes must be met or exceeded.

Facilitymedian $100 · 10th–90th $78–$1740%20%10th90th$100Professionalmedian $115 · 10th–90th $78–$2570%20%10th90th$115$1.0$5.0$20.0$100.0$500.0$2.0K

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
$77.62 / $100.00 / $173.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $114.82 / $257.04
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $114.82 / $154.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $107.15 / $154.88
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $138.04 / $213.80
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $138.04 / $173.78
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $154.88 / $269.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $120.23 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $134.90 / $204.17
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $134.90 / $223.87
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $120.23 / $151.36
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $138.04 / $194.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $112.20 / $177.83