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Illinois 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 $282 · 10th–90th $132–$6170%10%10th90th$282Professionalmedian $347 · 10th–90th $219–$8510%5%10%10th90th$347$100.0$200.0$500.0$1.0K$2.0K

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
$131.83 / $204.17 / $338.84
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $794.33 / $3,019.95
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $346.74 / $851.14
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $281.84