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Pennsylvania rates for HCPCS 99316

Nursing facility discharge management; more than 30 minutes total time on the date of the encounter

Facilitymedian $85 · 10th–90th $79–$2090%50%10th90th$85Professionalmedian $107 · 10th–90th $78–$1780%20%10th90th$107$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$79.43 / $85.11 / $208.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $107.15 / $177.83
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $112.20
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $125.89 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $125.89 / $190.55
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $42.66
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $199.53 / $234.42
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $112.20
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $81.28 / $100.00
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $100.00 / $186.21
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $107.15 / $128.82
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $107.15 / $128.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $114.82 / $194.98