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Nationwide rates for HCPCS 99236

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 high level of medical decision making. When using total time on the date of the encounter for code selection, 85 minutes must be met or exceeded.

Facilitymedian $251 · 10th–90th $162$6310%20%40%10th90th$251Professionalmedian $309 · 10th–90th $191$6310%20%10th90th$309$0.0$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$158.49 / $208.93 / $363.08
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$25.12 / $645.65 / $2,570.40
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $288.40 / $724.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $660.69 / $1,819.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $229.09 / $281.84