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First Doctor Visit After Nursing Facility Admission

Illinois rates for HCPCS 99306

The clinician's first visit to a patient who has just been admitted to a nursing facility. It covers a full review of the person's medical history and current problems, an examination, and setting out the plan of care for the stay, including medicines and goals.

Rates data updated July 2026.

How much does First Doctor Visit After Nursing Facility Admission cost?

$170

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $170 for this service. The price depends on where it is billed: about $170 from a physician practice, and about $155 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$170$138 to $200
FacilityA hospital or hospital-owned outpatient department$155$132 to $257

How much rates vary

Facilitymedian $155 · 10th to 90th $115 to $295Professionalmedian $170 · 10th to 90th $123 to $257
$100$200$500$1K$2Kfacility $155professional $170

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$154.88
Typical High
$281.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$154.88
Typical High
$229.09
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$177.83
Median
$181.97
Typical High
$501.19
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
BCBS
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$1,584.89
Typical High
$3,090.30
BCBS
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$208.93
Typical High
$239.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$245.47
Typical High
$302.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$251.19
Typical High
$457.09
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$223.87
Typical High
$239.88
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$173.78
United
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$288.40
Typical High
$549.54
United
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$186.21
Typical High
$309.03

Where Illinois sits

The same service costs 2.4 times more in Wyoming than in Alabama. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Illinois· 21st of 51

$170

WY $324AL $135

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.