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North Carolina rates for HCPCS 99203

Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.

Facilitymedian $117 · 10th–90th $76–$2140%10%10th90th$117Professionalmedian $117 · 10th–90th $71–$2690%5%10%10th90th$117$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
$69.18 / $117.49 / $218.78
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$128.82 / $165.96 / $223.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $112.20 / $269.15
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $120.23 / $275.42
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $112.20 / $165.96
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$89.13 / $112.20 / $177.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $141.25 / $234.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $125.89 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $114.82 / $204.17
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $114.82 / $208.93
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $109.65 / $177.83
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $269.15
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $134.90 / $239.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $93.33 / $138.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $100.00 / $165.96
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $128.82 / $177.83
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $691.83