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New York rates for HCPCS 99306

Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 50 minutes must be met or exceeded.

Facilitymedian $219 · 10th–90th $148–$3630%20%40%10th90th$219Professionalmedian $174 · 10th–90th $120–$3390%20%10th90th$174$0.1$1.0$10.0$100.0$1.0K$10.0K

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
$165.96 / $218.78 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $173.78 / $338.84
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $141.25 / $302.00
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $234.42
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $234.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $50,118.72 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $223.87 / $851.14
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.10 / $162.18 / $416.87
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $338.84 / $562.34
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $169.82 / $169.82
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $147.91 / $331.13
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,000.00
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $173.78
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $181.97 / $346.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $229.09 / $575.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $194.98 / $354.81
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $173.78 / $316.23
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $173.78 / $489.78