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Montana rates for HCPCS 99281

Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional

Facilitymedian $22 · 10th–90th $17–$590%20%10th90th$22Professionalmedian $28 · 10th–90th $8–$660%5%10th90th$28$10.0$20.0$50.0$100.0$200.0

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
$223.87 / $223.87 / $223.87
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $27.54 / $66.07
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$21.88 / $39.81 / $39.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $21.38 / $35.48
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $19.95 / $38.90
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.96 / $30.20 / $61.66
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $34.67 / $47.86
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11