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Nebraska rates for HCPCS 99235

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 moderate level of medical decision making. When using total time on the date of the encounter for code selection, 70 minutes must be met or exceeded.

Facilitymedian $302 · 10th–90th $120–$4270%20%10th90th$302Professionalmedian $316 · 10th–90th $229–$4270%20%10th90th$316$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
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $302.00 / $302.00
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $398.11
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $257.04 / $707.95
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $316.23 / $426.58