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North Carolina rates for HCPCS 99202

Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.

Facilitymedian $79 · 10th–90th $48–$1410%10%10th90th$79Professionalmedian $81 · 10th–90th $48–$1740%5%10%10th90th$81$10.0$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $89.13 / $144.54
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$95.50 / $134.90 / $147.91
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $77.62 / $173.78
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$54.95 / $87.10 / $194.98
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $70.79 / $114.82
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$57.54 / $70.79 / $117.49
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $91.20 / $162.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $125.89 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $77.62 / $141.25
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $79.43 / $134.90
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $72.44 / $117.49
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $190.55
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $79.43 / $154.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $63.10 / $87.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $67.61 / $112.20
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $79.43 / $144.54
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $457.09