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Illinois rates for HCPCS 99310

Subsequent 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, 45 minutes must be met or exceeded.

Facilitymedian $191 · 10th–90th $98–$4370%10%10th90th$191Professionalmedian $132 · 10th–90th $102–$2090%10%10th90th$132$50.0$100.0$200.0$500.0$1.0K$2.0K

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 / $144.54 / $239.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $128.82 / $204.17
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$30.20 / $125.89 / $389.05
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $562.34 / $2,187.76
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $173.78 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $204.17 / $245.47
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $218.78 / $389.05
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $190.55 / $204.17
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $173.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $154.88 / $239.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $151.36 / $239.88