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Wisconsin rates for HCPCS 99309

Subsequent 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, 30 minutes must be met or exceeded.

Facilitymedian $93 · 10th–90th $71–$3240%10%10th90th$93Professionalmedian $100 · 10th–90th $72–$2340%10%10th90th$100$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $91.20 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $95.50 / $190.55
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$20.42 / $102.33 / $102.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $151.36 / $269.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $331.13 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $269.15 / $363.08
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $120.23 / $218.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $120.23 / $218.78
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $151.36 / $245.47
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $208.93
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $177.83
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $263.03 / $363.08
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $562.34
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $229.09 / $616.60
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $316.23 / $354.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $87.10 / $87.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $131.83 / $239.88