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South Carolina rates for HCPCS 99205

Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.

Facilitymedian $214 · 10th–90th $138–$3390%10%10th90th$214Professionalmedian $214 · 10th–90th $141–$4790%10%10th90th$214$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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
$128.82 / $181.97 / $295.12
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $1,380.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $204.17 / $446.68
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$165.96 / $269.15 / $562.34
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $223.87 / $354.81
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$162.18 / $223.87 / $389.05
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $257.04 / $549.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $144.54 / $204.17
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $104.71 / $281.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $213.80 / $363.08
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $223.87 / $257.04
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $223.87 / $354.81
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $114.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $194.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $186.21 / $295.12
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $91.20 / $478.63