Online digital evaluation and management service for an established patient for up to 7 days, total time 21 or more minutes
Medicare pricing data for 3,104 providers across 42 states
Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Online digital evaluation and management service for an established patient for up to 7 days, total time 21 or more minutes (HCPCS code 99423) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $44.50, but hospitals typically charge $93.19 — a 2.1x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $44.50, your out-of-pocket cost would be approximately $8.90. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 2.1x more than what Medicare allows for this procedure. Medicare actually pays $33.64 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| New York | $51 | $109 | 127 | 1,966 | +14.1% |
| District of Columbia | $50 | $105 | 24 | 108 | +12.9% |
| New Jersey | $50 | $98 | 53 | 632 | +12.4% |
| Alaska | $49 | $185 | 12 | 21 | +11.1% |
| California | $49 | $149 | 601 | 5,864 | +10.6% |
| Maryland | $48 | $118 | 106 | 478 | +7.8% |
| Connecticut | $47 | $148 | 13 | 30 | +5.1% |
| Massachusetts | $46 | $141 | 21 | 63 | +3.5% |
| Washington | $45 | $131 | 125 | 281 | +1.7% |
| Hawaii | $45 | $123 | 17 | 37 | +1.4% |
| Missouri | $45 | $61 | 22 | 263 | +1.0% |
| New Mexico | $45 | $105 | 16 | 88 | +0.4% |
| Florida | $45 | $90 | 185 | 1,381 | +0.1% |
| Texas | $44 | $80 | 287 | 16,421 | -0.6% |
| Nevada | $43 | $131 | 21 | 177 | -2.4% |
| Georgia | $43 | $105 | 42 | 288 | -2.8% |
| Louisiana | $43 | $163 | 14 | 119 | -3.5% |
| Pennsylvania | $43 | $119 | 99 | 283 | -3.8% |
| Minnesota | $43 | $125 | 96 | 163 | -3.9% |
| Delaware | $43 | $61 | 4 | 52 | -4.3% |
| Michigan | $42 | $95 | 174 | 604 | -4.8% |
| Virginia | $42 | $90 | 69 | 232 | -4.8% |
| Illinois | $42 | $74 | 169 | 11,635 | -4.9% |
| Maine | $42 | $114 | 10 | 28 | -5.9% |
| Arizona | $42 | $109 | 72 | 257 | -6.1% |
| Tennessee | $42 | $118 | 60 | 236 | -6.2% |
| Oregon | $42 | $138 | 33 | 121 | -6.7% |
| Mississippi | $41 | $70 | 5 | 11 | -6.9% |
| North Carolina | $41 | $114 | 120 | 663 | -6.9% |
| Colorado | $41 | $113 | 28 | 63 | -8.2% |
| Alabama | $40 | $87 | 8 | 13 | -9.5% |
| South Carolina | $40 | $88 | 38 | 141 | -9.7% |
| Ohio | $40 | $101 | 178 | 404 | -11.2% |
| Wisconsin | $40 | $120 | 33 | 49 | -11.2% |
| Oklahoma | $39 | $60 | 25 | 258 | -13.1% |
| Kentucky | $38 | $83 | 23 | 182 | -13.9% |
| Iowa | $38 | $174 | 17 | 32 | -14.7% |
| Utah | $37 | $118 | 11 | 36 | -16.3% |
| Nebraska | $37 | $76 | 23 | 207 | -16.9% |
| Indiana | $36 | $103 | 21 | 33 | -18.9% |
| Puerto Rico | $35 | $49 | 8 | 24 | -20.6% |
| Kansas | $35 | $121 | 7 | 30 | -21.1% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber