go back

Delaware rates for HCPCS 99254

Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.

Facilitymedian $8 · 10th–90th $8–$1510%50%90th$8Professionalmedian $162 · 10th–90th $115–$4070%10%10th90th$162$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.32 / $8.32 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $162.18 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $177.83 / $257.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $165.96 / $302.00