go back

Wisconsin 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 $110 · 10th–90th $78–$1950%10%20%10th90th$110Professionalmedian $135 · 10th–90th $79–$3890%5%10th90th$135$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
$77.62 / $102.33 / $186.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $128.82 / $389.05
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $158.49 / $309.03
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $138.04 / $194.98
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $251.19 / $302.00
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $123.03 / $199.53
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $251.19 / $295.12
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $123.03 / $199.53
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $208.93 / $707.95
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $50.12 / $85.11
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $251.19 / $478.63
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $234.42 / $331.13
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $707.95 / $707.95
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $562.34 / $707.95
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $338.84 / $338.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $123.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $263.03 / $371.54