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Wisconsin 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 $224 · 10th–90th $135–$6310%10%10th90th$224Professionalmedian $479 · 10th–90th $302–$6310%10%20%10th90th$479$100.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $177.83 / $380.19
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $288.40 / $407.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $630.96 / $1,000.00
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $223.87 / $416.87
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $223.87 / $416.87
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $426.58
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $489.78 / $630.96
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $1,288.25 / $1,288.25
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $371.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $141.25