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New Jersey 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 $71–$1550%20%10th90th$93Professionalmedian $129 · 10th–90th $79–$2510%10%10th90th$129$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
$70.79 / $93.33 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $128.82 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $151.36 / $302.00
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $138.04 / $208.93
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $125.89 / $208.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $79.43 / $134.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $114.82 / $223.87