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Virginia 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 $257 · 10th–90th $162–$1,0000%5%10%10th90th$257Professionalmedian $245 · 10th–90th $186–$3890%20%10th90th$245$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$162.18 / $213.80 / $776.25
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$645.65 / $645.65 / $2,570.40
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $239.88 / $707.95
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $316.23 / $389.05
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $281.84 / $426.58
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $269.15 / $1,023.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $229.09