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Texas 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 $148 · 10th–90th $74–$4170%10%20%10th90th$148Professionalmedian $132 · 10th–90th $76–$2750%10%10th90th$132$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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
$72.44 / $75.86 / $173.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $131.83 / $275.42
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $97.72 / $165.96
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $323.59 / $588.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $95.50 / $162.18
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $120.23 / $173.78
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $138.04 / $229.09
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $144.54 / $234.42
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $134.90 / $234.42
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $83.18 / $97.72
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $100.00 / $109.65
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $147.91 / $245.47
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $138.04 / $239.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $120.23 / $131.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $125.89 / $199.53
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $100.00 / $120.23