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Washington 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 $282 · 10th–90th $182–$3890%10%10th90th$282$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $281.84 / $389.05
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $316.23 / $398.11
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $309.03 / $323.59
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $218.78 / $218.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36