go back

Utah 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 $123 · 10th–90th $115–$1350%20%40%10th90th$123Professionalmedian $115 · 10th–90th $79–$2190%10%10th90th$115$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
$114.82 / $114.82 / $134.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $114.82 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $162.18 / $269.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $177.83
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $138.04 / $181.97
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $144.54 / $512.86
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $141.25 / $199.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $138.04 / $199.53