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Washington 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 $178 · 10th–90th $123–$2510%10%10th90th$178Professionalmedian $138 · 10th–90th $85–$3630%10%10th90th$138$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
$123.03 / $177.83 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $134.90 / $380.19
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $147.91 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $194.98 / $295.12
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $199.53 / $251.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $199.53 / $269.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $95.50 / $190.55
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $194.98 / $218.78
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $147.91 / $295.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $95.50 / $190.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $158.49 / $281.84
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $114.82 / $204.17