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Maine 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 $316 · 10th–90th $316–$5,0120%20%40%90th$316Professionalmedian $123 · 10th–90th $81–$1950%10%10th90th$123$10.0$50.0$200.0$1.0K$5.0K

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
$316.23 / $316.23 / $5,011.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $123.03 / $190.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $117.49 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $147.91 / $223.87
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $147.91 / $257.04
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $123.03 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $158.49 / $229.09