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Procedure price report · Consultation, evaluation, and preventative care

Staff care management for one illness, first 30 minutes

CPT 99426the billing code this page is about

Monthly care coordination for a single serious condition carried out by clinical staff under provider direction; this code covers the first 30 minutes in a calendar month.

Hospitals typically charge $99 cash for this outpatient procedure — the median across 337 hospitals that filed a usable cash price; the average of the middle 60% is $101. Most fall between $64 and $159 (20th–80th percentile).

Hospitals
337
States
39
Filings dated
May 2025 – Sep 2026
Computed
September 25, 2026
Prices checked
through September 24, 2026

Median: half of hospitals filed less, half more — and it is a price some hospital actually filed. Average of the middle 60%: the mean of the prices between the 20th and 80th percentiles. We never publish the plain average, the lowest or the highest price: the extremes in hospital price files are chargemaster artefacts, not prices anyone pays.

What hospitals charge, from cheapest to most expensive

Cash price percentiles, outpatient, across 337 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$49$74$99$134$235

The most expensive tenth of hospitals charges at least 4.8× what the cheapest tenth charges ($49 vs $235).

How the prices are spread

$30 – $38: 11 hospitals$30$38 – $48: 7 hospitals$48 – $60: 22 hospitals$48$60 – $75: 49 hospitals$75 – $94: 56 hospitals$75$94 – $118: 67 hospitals$118 – $148: 35 hospitals$118$148 – $186: 24 hospitals$186 – $234: 16 hospitals$186$234 – $293: 19 hospitals$234median $99price bands are equal on a log scale
Hospitals per price band (306 of 337 — the bands cover the 5th to 95th percentile)
FromToHospitals
$30$3811
$38$487
$48$6022
$60$7549
$75$9456
$94$11867
$118$14835
$148$18624
$186$23416
$234$29319

Against Medicare

Medicare pays (OPPS 2026, national rate)$104
Median cash price$99
Cash as a multiple of Medicare0.95×

The Medicare figure is the national unadjusted OPPS rate for this code — what Medicare itself pays a hospital before local wage adjustment. It is a benchmark, not a price anyone is charged.

By state

The median cash price in each state, against the national median of $99.

Alaska: no hospital in the corpus filed a usable priceAKMaine: 2 hospitals filed a usable price — fewer than 10, so no figureMEVermont: 1 hospital filed a usable price — fewer than 10, so no figureVTNew Hampshire: 3 hospitals filed a usable price — fewer than 10, so no figureNHWashington: median $123 across 11 hospitalsWA$123Idaho: 3 hospitals filed a usable price — fewer than 10, so no figureIDMontana: 7 hospitals filed a usable price — fewer than 10, so no figureMTNorth Dakota: no hospital in the corpus filed a usable priceNDMinnesota: 9 hospitals filed a usable price — fewer than 10, so no figureMNIllinois: median $105 across 16 hospitalsIL$105Wisconsin: median $90 across 27 hospitalsWI$90Michigan: median $105 across 23 hospitalsMI$105New York: median $109 across 30 hospitalsNY$109Massachusetts: 3 hospitals filed a usable price — fewer than 10, so no figureMAOregon: median $124 across 15 hospitalsOR$124Nevada: 2 hospitals filed a usable price — fewer than 10, so no figureNVWyoming: 2 hospitals filed a usable price — fewer than 10, so no figureWYSouth Dakota: 1 hospital filed a usable price — fewer than 10, so no figureSDIowa: 6 hospitals filed a usable price — fewer than 10, so no figureIAIndiana: median $87 across 19 hospitalsIN$87Ohio: median $113 across 14 hospitalsOH$113Pennsylvania: median $36 across 15 hospitalsPA$36New Jersey: median $102 across 11 hospitalsNJ$102Connecticut: no hospital in the corpus filed a usable priceCTRhode Island: no hospital in the corpus filed a usable priceRICalifornia: median $165 across 10 hospitalsCA$165Utah: no hospital in the corpus filed a usable priceUTColorado: 2 hospitals filed a usable price — fewer than 10, so no figureCONebraska: 8 hospitals filed a usable price — fewer than 10, so no figureNEMissouri: 1 hospital filed a usable price — fewer than 10, so no figureMOKentucky: median $424 across 13 hospitalsKY$424West Virginia: median $81 across 14 hospitalsWV$81Virginia: no hospital in the corpus filed a usable priceVAMaryland: no hospital in the corpus filed a usable priceMDDelaware: 2 hospitals filed a usable price — fewer than 10, so no figureDEArizona: 3 hospitals filed a usable price — fewer than 10, so no figureAZNew Mexico: no hospital in the corpus filed a usable priceNMKansas: 2 hospitals filed a usable price — fewer than 10, so no figureKSArkansas: 1 hospital filed a usable price — fewer than 10, so no figureARTennessee: 5 hospitals filed a usable price — fewer than 10, so no figureTNNorth Carolina: no hospital in the corpus filed a usable priceNCSouth Carolina: 3 hospitals filed a usable price — fewer than 10, so no figureSCOklahoma: 3 hospitals filed a usable price — fewer than 10, so no figureOKLouisiana: no hospital in the corpus filed a usable priceLAMississippi: 2 hospitals filed a usable price — fewer than 10, so no figureMSAlabama: 2 hospitals filed a usable price — fewer than 10, so no figureALGeorgia: 1 hospital filed a usable price — fewer than 10, so no figureGAHawaii: no hospital in the corpus filed a usable priceHITexas: median $92 across 37 hospitalsTX$92Florida: 8 hospitals filed a usable price — fewer than 10, so no figureFL
Cash price by state, most expensive first. National median $99. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
Kentucky KY13$424+329%$60 – $424
California CA10$165+66%$85 – $235
Oregon OR15$124+25%$117 – $132
Washington WA11$123+24%$101 – $172
Ohio OH14$113+14%$79 – $260
New York NY30$109+11%$53 – $127
Illinois IL16$105+6%$60 – $240
Michigan MI23$105+6%$64 – $181
New Jersey NJ11$102+4%$102 – $109
Texas TX37$92−7%$74 – $92
Wisconsin WI27$90−9%$75 – $182
Indiana IN19$87−12%$60 – $124
West Virginia WV14$81−18%$51 – $117
Pennsylvania PA15$36−64%$30 – $99
Minnesota MN9not enough hospitals filed a usable price
Florida FL8not enough hospitals filed a usable price
Nebraska NE8not enough hospitals filed a usable price
Montana MT7not enough hospitals filed a usable price
Iowa IA6not enough hospitals filed a usable price
Tennessee TN5not enough hospitals filed a usable price
Arizona AZ3not enough hospitals filed a usable price
Idaho ID3not enough hospitals filed a usable price
Massachusetts MA3not enough hospitals filed a usable price
New Hampshire NH3not enough hospitals filed a usable price
Oklahoma OK3not enough hospitals filed a usable price
South Carolina SC3not enough hospitals filed a usable price
Alabama AL2not enough hospitals filed a usable price
Colorado CO2not enough hospitals filed a usable price
Delaware DE2not enough hospitals filed a usable price
Kansas KS2not enough hospitals filed a usable price
Maine ME2not enough hospitals filed a usable price
Mississippi MS2not enough hospitals filed a usable price
Nevada NV2not enough hospitals filed a usable price
Wyoming WY2not enough hospitals filed a usable price
Arkansas AR1not enough hospitals filed a usable price
Georgia GA1not enough hospitals filed a usable price
Missouri MO1not enough hospitals filed a usable price
South Dakota SD1not enough hospitals filed a usable price
Vermont VT1not enough hospitals filed a usable price

Hospitals like yours

The same distribution cut by the kind of hospital. Hospital type and ownership come from CMS; a hospital counts as part of a system when its price file is shared with at least one other hospital under the same brand. The national median is $99.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care250$102$65 – $179
Children’s1fewer than 20 hospitals
Critical access85$88$60 – $132
Ownership
For-profit31$92$60 – $117
Government56$109$84 – $162
Non-profit249$92$64 – $168
System affiliation
Part of a system271$96$64 – $159
Independent66$105$60 – $162

Cash price vs list price

Median list price (chargemaster)$166
Median cash price$99
Cash as a share of list, median hospital60%

At the typical hospital, asking for the cash price cuts the list price by about 40%. The share is the median of each hospital’s own cash ÷ list ratio, over hospitals that filed both — not the ratio of the two medians above.

The same procedure, inpatient

211 hospitals filed a usable inpatient cash price for this code. The median is $92 and the average of the middle 60% is $98; most fall between $60 and $173.

Cash price percentiles, inpatient, across 211 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$46$68$92$158$206

The most expensive tenth of hospitals charges at least 4.5× what the cheapest tenth charges ($46 vs $206).

Of the 216 hospitals that filed this code inpatient, 211 gave a usable cash price; 1 carried a plausibility flag, 0 filed a number their own filing marks as not a price, 0 gave an estimate, and 4 a list price only.

How complete is this

337 of the 3,956 hospitals with a price file in our corpus (9%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 344 hospitals that filed this code at all gave us
Usable cash price — counted337
Cash price carrying a plausibility flag — shown on the compare tool, excluded here1
A number the filing itself marks as not a price (a placeholder, a ratio) — excluded0
An estimate rather than a filed cash price — excluded0
A list price only, no cash figure — excluded6
Hospitals that filed this code344

Sections not shown for this setting

  • Since our last snapshot: there is no earlier snapshot at least 90 days older than this one yet.

We last checked these hospitals’ price files for changes between September 4, 2026 and September 24, 2026; the figures were computed September 25, 2026 from filings loaded through September 24, 2026. The percentiles and averages use only the “counted” row.

Related procedures

Part of the Consultation, evaluation, and preventative care family.

Hospitals file this code under descriptions such as PRIN CARE MGMT STAFF 1ST 30.

Method

Source
The machine-readable price files every U.S. hospital is required by CMS to publish, parsed per hospital. Nothing is surveyed, sampled or modelled.
What counts
One cash (self-pay) price per hospital for this code and setting. A hospital’s own filing can rule its number out — a placeholder, a “not applicable” note, a list price standing in for cash — and our plausibility checks can flag a price far below what every other hospital files. Both kinds are disclosed above and excluded from the statistics; on the compare tool a flagged price is still shown.
Statistics
Percentiles are discrete: each is a price some hospital filed. The average is the mean of the prices between the 20th and 80th percentiles. We never publish the plain mean, the minimum or the maximum. A state needs 10 hospitals and a segment 20 to show a figure; otherwise the row shows its count and no number. Medicare is the national unadjusted OPPS rate where one exists.
Names
Procedure names on these pages are our own plain-language titles, not the AMA’s copyrighted CPT descriptors. The code is the identity.

The full rules — sources, statistics, thresholds, limitations — are on the methodology page.

Download this page’s figures: JSON · CSV. Aggregates only — the per-hospital prices are on the compare tool.

Cite: HospitalRates.com, “Staff care management for one illness, first 30 minutes (CPT 99426) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-99426-staff-care-management-for-one-illness-first-30-minutes