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Pennsylvania rates for HCPCS 99234

Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.84 / $120.79 / $348.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,000.00 / $8,639.91 / $79,506.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.66 / $111.66 / $111.66
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.84 / $104.83 / $284.38
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.66 / $111.66 / $111.66
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$96.70 / $96.70 / $149.82