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Wisconsin 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 $112 · 10th–90th $85–$3470%10%20%10th90th$112Professionalmedian $117 · 10th–90th $79–$3470%10%10th90th$117$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
$75.86 / $112.20 / $218.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $114.82 / $346.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $169.82 / $302.00
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $165.96 / $229.09
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $269.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $363.08 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $269.15 / $338.84
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $107.15 / $213.80
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $269.15 / $331.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $107.15 / $213.80
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $223.87 / $707.95
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $134.90
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $204.17
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $194.98 / $323.59
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $251.19 / $354.81
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $707.95 / $707.95
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $512.86 / $691.83
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $173.78
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $346.74 / $398.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $239.88 / $338.84