▸ Procedure · inpatient · CPT 99221
Initial hospital care, low complexity
What US hospitals charge for initial hospital care, low complexity — negotiated rates by payer + state-by-state pricing.
Hospitals
625
Rate rows
20,167
Neg. median
$92.96
Neg. min
$1
Neg. max
$40,909
Cash median
$166.05
Across 625 US hospitals publishing MRFs, the negotiated rate for Initial hospital care, low complexity ranges from $1 to $40,909, with a median of $92.96. Half of all rates fall between $72.73 and $211.13. Cash-pay patients typically pay $166.05; hospital list (gross) prices median $283.
By payer
Top 30 payers by hospital coverage for this code.
| Payer | Hospitals | Rates | Median rate |
|---|---|---|---|
| UnitedHealthcare | 354 | 1463 | $96.47 |
| Blue Cross Blue Shield | 353 | 2032 | $99.71 |
| Aetna | 320 | 1156 | $80 |
| Cigna | 256 | 583 | $111 |
| Humana | 233 | 477 | $77.67 |
| WellCare | 131 | 214 | $77.82 |
| Multiplan | 113 | 371 | $309.4 |
| First Health | 94 | 282 | $303.17 |
| Medicaid | 82 | 666 | $54.5 |
| Molina | 69 | 219 | $76.22 |
| Medicare | 65 | 532 | $78.55 |
| amerihealth | 58 | 153 | $94.32 |
| medcost | 56 | 110 | $211.13 |
| medica | 44 | 459 | $237.46 |
| choicecare | 38 | 42 | $160.48 |
| health partners open network | 37 | 37 | $167.73 |
| amerihealth caritas | 37 | 41 | $90.3 |
| healthy blue | 35 | 35 | $90.3 |
| carolina complete health | 35 | 35 | $90.3 |
| Ambetter | 34 | 37 | $171.19 |
| alliance | 34 | 34 | $91.2 |
| fidelis care | 33 | 55 | $69.09 |
| health partners | 33 | 297 | $304.85 |
| meridian | 33 | 62 | $62.91 |
| trillium | 32 | 32 | $89.41 |
| sanford health plan | 32 | 249 | $218.52 |
| partners | 32 | 32 | $90.3 |
| Self-Pay (Cash) | 31 | 31 | $20.83 |
| phcs | 30 | 48 | $134.71 |
| vaya | 30 | 30 | $90.3 |
By state
States with ≥2 reporting hospitals.
| State | Hospitals | Median rate |
|---|---|---|
| AL | 9 | $202.15 |
| AR | 3 | $94.67 |
| AZ | 3 | $163.4 |
| CA | 5 | $191.29 |
| CO | 2 | $81.29 |
| DE | 2 | $78.95 |
| GA | 4 | $78.87 |
| HI | 6 | $81.13 |
| IA | 25 | $143.04 |
| IL | 36 | $78.65 |
| IN | 16 | $97.63 |
| KS | 10 | $136.4 |
| KY | 8 | $72.79 |
| LA | 2 | $288.88 |
| MA | 7 | $85 |
| MD | 3 | $107.43 |
| MI | 25 | $97 |
| MN | 17 | $279.71 |
| MO | 6 | $61.76 |
| MS | 4 | $76.87 |
| NC | 21 | $75.15 |
| ND | 5 | $135.6 |
| NE | 2 | $107.7 |
| NJ | 12 | $85 |
| NY | 8 | $90.15 |
| OH | 5 | $79 |
| OK | 3 | $94.08 |
| PA | 14 | $106 |
| SC | 4 | $72.73 |
| TN | 12 | $148 |
| TX | 23 | $97.63 |
| VA | 2 | — |
| VT | 5 | $91.59 |
| WA | 3 | $92.43 |
| WI | 17 | $140.27 |
| WV | 10 | $67.66 |
Top 20 by lowest negotiated rate
Lowest median negotiated rate among hospitals publishing for this code.
| Hospital | City | ST | Negotiated median |
|---|---|---|---|
| COASTAL CAROLINA MEDICAL CENTER | HARDEEVILLE | SC | $33.6 |
| EAST COOPER REGIONAL MEDICAL CENTER | MT. PLEASANT | SC | $36.9 |
| Scripps Mercy Hospital Chula Vista | — | — | $42.29 |
| Scripps Memorial Hospital La Jolla | — | — | $42.29 |
| Green Hospital Of Scripps Clinic | — | — | $42.29 |
| Scripps Green Hospital | — | — | $42.29 |
| Scripps Memorial Hospital Encinitas | — | — | $42.29 |
| HILTON HEAD HOSPITAL | HILTON HEAD ISLAND | SC | $42.8 |
| Scripps Mercy Hospital | SAN DIEGO | CA | $43.41 |
| Eastland Memorial Hospital | EASTLAND | TX | $47.5 |
| Clay County Memorial Hospital | HENRIETTA | TX | $50 |
| Henry Ford Rochester Hospital | — | — | $50 |
| Kahuku Medical Center | KAHUKU | HI | $53.33 |
| Kohala Hospital | KAPAAU | HI | $53.33 |
| Robert Wood Johnson University Hospital Rahway | — | — | $54.82 |
| Carle BroMenn Medical Center - Rehab Unit | — | — | $60.45 |
| Carle BroMenn Medical Center | — | — | $60.45 |
| Carle Bromenn Medical Center | NORMAL | IL | $60.45 |
| Carle Health Pekin Hospital | — | — | $60.8 |
| Ranken Jordan Pediatric Bridge Hospital | MARYLAND HEIGHTS | MO | $61.76 |