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Illinois 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 $138 · 10th–90th $78–$3720%10%10th90th$138Professionalmedian $132 · 10th–90th $81–$3020%5%10%10th90th$132$10.0$50.0$200.0$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
$77.62 / $107.15 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $128.82 / $302.00
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $97.72 / $239.88
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $467.74 / $1,621.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $138.04 / $204.17
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $173.78 / $446.68
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $123.03 / $131.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $46.77 / $131.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $120.23 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $144.54 / $234.42