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Oregon 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 $398 · 10th–90th $234–$5130%20%10th90th$398Professionalmedian $407 · 10th–90th $302–$4900%20%10th90th$407$200.0$500.0$1.0K

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
$257.04 / $467.74 / $1,380.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $316.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $407.38 / $489.78
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $316.23 / $512.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $407.38 / $416.87
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $316.23 / $512.86