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Follow-Up Care After Leaving the Hospital, Moderate

Pennsylvania rates for HCPCS 99495

This service covers coordinated follow-up care provided to a patient during the weeks after being discharged from a hospital or facility stay, including a check-in and a required follow-up office visit. It applies to cases involving a moderate level of medical decision-making during that transition period.

Rates data updated October 2026.

How much does Follow-Up Care After Leaving the Hospital, Moderate cost?

$162

Typical negotiated rate. In Pennsylvania, October 2026.

Insurers have agreed to pay about $162 for this service. The price depends on where it is billed: about $162 from a physician practice, and about $200 from a hospital or other facility.

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 13 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$162$112 to $204
FacilityA hospital or hospital-owned outpatient department$200$138 to $363

How much rates vary

Facilitymedian $200 · 10th to 90th $117 to $589Professionalmedian $162 · 10th to 90th $110 to $214
$100$500$2K$10K$50Kfacility $200professional $162

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$109.65
Median
$162.18
Typical High
$169.82
Aetna
Setting
Professional
Modifier
None
Typical Low
$109.65
Median
$147.91
Typical High
$162.18
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$54.95
Median
$69.18
Typical High
$81.28
Ambetter
Setting
Professional
Modifier
None
Typical Low
$177.83
Median
$177.83
Typical High
$407.38
AmeriHealth
Setting
Professional
Modifier
None
Typical Low
$181.97
Median
$213.80
Typical High
$229.09
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$4,265.80
Median
$5,011.87
Typical High
$79,432.82
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$213.80
Typical High
$213.80
Cigna
Setting
Professional
Modifier
None
Typical Low
$128.82
Median
$186.21
Typical High
$275.42
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$371.54
Median
$371.54
Typical High
$371.54
Geisinger
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$177.83
Typical High
$354.81
Highmark BCBS
Setting
Facility
Modifier
None
Typical Low
$77.62
Median
$407.38
Typical High
$602.56
Independence Blue Cross
Setting
Professional
Modifier
None
Typical Low
$194.98
Median
$213.80
Typical High
$213.80
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$109.65
Median
$162.18
Typical High
$169.82
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$109.65
Median
$147.91
Typical High
$162.18
Martin's Point
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$54.95
Median
$67.61
Typical High
$81.28
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$128.82
Median
$128.82
Typical High
$128.82
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$120.23
Median
$199.53
Typical High
$363.08
UPMC Health Plan
Setting
Professional
Modifier
None
Typical Low
$120.23
Median
$144.54
Typical High
$199.53
United
Setting
Facility
Modifier
None
Typical Low
$181.97
Median
$389.05
Typical High
$446.68
United
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$177.83
Typical High
$281.84

Where Pennsylvania sits

The same service costs 2.8 times more in Alaska than in Kentucky. 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.

Pennsylvania· 31st of 51

$162

AK $339KY $120

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.