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Indiana 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 $93 · 10th–90th $76–$1350%20%10th90th$93Professionalmedian $126 · 10th–90th $79–$3020%5%10%10th90th$126$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
$72.44 / $89.13 / $131.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $125.89 / $309.03
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $104.71
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $223.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $117.49 / $181.97
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $120.23 / $151.36
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $117.49 / $147.91
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $117.49 / $154.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $117.49 / $194.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $128.82 / $131.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $117.49 / $173.78