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Initial hospital care, high complexity

CPT 99223 · negotiated-rate distribution across hospitals in CA

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Hospitals
6
Min
$141.71
Median
$394.15
Max
$499.05
Range multiplier
3.5×

By payer (27 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare410$165.81$384.66$726.54.4×
Blue Cross Blue Shield48$127.42$375.12$797.556.3×
Cigna48$149.7$287.33$479.213.2×
Kaiser Permanente47$113.75$247.15$470.94.1×
Aetna56$127.42$258.75$655.35.1×
Anthem BCBS25$113.75$394.4$452.574.0×
Health Net33$380.96$389$447.081.2×
veba med grp [813]12$215.08$257.55$300.011.4×
First Health22$388.08$448.88$509.681.3×
hn [815]12$159.18$190.61$222.041.4×
Medicaid22$113.75$254.88$3963.5×
Multiplan22$388.08$465.5$542.921.4×
uh [819]12$165.81$198.55$231.291.4×
altamed11$460$460$4601.0×
Humana11$127.42$127.42$127.421.0×
beech st [10600]11$426.22$426.22$426.221.0×
umr [17000]11$726.5$726.5$726.51.0×
Medicare11$127.42$127.42$127.421.0×
Molina11$460$460$4601.0×
american specialty health plan alt payer [971000000]11$797.55$797.55$797.551.0×
private healthcare systems (phcs) [14200]11$426.22$426.22$426.221.0×
shca comm intel [20300000]11$571.88$571.88$571.881.0×
claritev [13400]11$426.22$426.22$426.221.0×
the health plan11$130.48$130.48$130.481.0×
blue card (out of state) [40000]11$571.88$571.88$571.881.0×
health plan of san mateo [31200]11$140.18$140.18$140.181.0×
heritage provider network11$460$460$4601.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
STANFORD HEALTH CARESTANFORDCA14$838$419$140.18$499.05$797.55
PACIFICA HOSPITAL OF THE VALLEYSUN VALLEYCA5$460$460$230$460$460
MARK TWAIN MEDICAL CENTERSAN ANDREASCA12$554$387.8$113.75$394.15$542.92
ST ELIZABETH COMMUNITY HOSPTIALRED BLUFFCA10$396$277.2$238.4$384.52$396
SCRIPPS MERCY HOSPITALSAN DIEGOCA6$660.82$165.2$149.7$211.95$300.01
SAN ANTONIO REGIONAL HOSPITALUPLANDCA2$321$192.6$130.48$141.71$152.94

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.