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Kentucky 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 $95 · 10th–90th $79–$1410%20%10th90th$95Professionalmedian $123 · 10th–90th $81–$1910%10%10th90th$123$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
$79.43 / $95.50 / $104.71
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $123.03 / $190.55
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $100.00 / $123.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $95.50 / $154.88
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $123.03 / $151.36
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $114.82 / $151.36
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $154.88 / $154.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $181.97 / $467.74
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $77.62 / $100.00
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
$95.50 / $120.23 / $194.98