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California rates for HCPCS 99253

Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.

Facilitymedian $120 · 10th–90th $95–$3020%20%40%10th90th$120Professionalmedian $141 · 10th–90th $91–$3980%10%20%10th90th$141$0.0$0.2$2.0$20.0$200.0

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
$97.72 / $123.03 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $141.25 / $398.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $120.23 / $302.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $154.88 / $316.23
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $154.88 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $144.54 / $275.42
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $46.77 / $56.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $309.03 / $467.74
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $134.90 / $478.63
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $144.54 / $229.09
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $147.91 / $288.40
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $64.57 / $104.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $131.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $128.82 / $316.23