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Georgia 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 $115 · 10th–90th $93–$1550%20%10th90th$115Professionalmedian $132 · 10th–90th $85–$2880%5%10%10th90th$132$10.0$20.0$50.0$100.0$200.0$500.0

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
$93.33 / $112.20 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $131.83 / $288.40
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $177.83 / $213.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $128.82 / $204.17
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $134.90 / $194.98
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $120.23 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $151.36 / $229.09
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $134.90 / $263.03
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $218.78 / $281.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $134.90 / $269.15