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Nationwide rates for HCPCS 99305

Initial nursing facility care, per day, for the evaluation and management of a 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, 35 minutes must be met or exceeded.

Facilitymedian $141 · 10th–90th $100$2630%50%10th90th$141Professionalmedian $126 · 10th–90th $95$2340%50%10th90th$126$0.0$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$97.72 / $125.89 / $204.17
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$91.20 / $91.20 / $91.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $125.89 / $204.17
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $128.82 / $147.91
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $162.18 / $407.38
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $131.83 / $257.04
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $467.74 / $1,174.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $223.87 / $446.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $125.89 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $141.25 / $269.15