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Montana 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 $170 · 10th–90th $141–$3090%50%10th90th$170Professionalmedian $132 · 10th–90th $83–$2690%20%10th90th$132$10.0$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $131.83 / $269.15
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64,565.42 / $77,624.71 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $144.54 / $190.55
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $173.78 / $190.55
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $173.78 / $190.55
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $158.49 / $275.42
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $154.88 / $251.19
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
$112.20 / $186.21 / $223.87