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North Carolina rates for HCPCS 99212

Office or other outpatient visit for the evaluation and management of an established 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, 10 minutes must be met or exceeded.

Facilitymedian $62 · 10th–90th $35–$2040%5%10th90th$62Professionalmedian $54 · 10th–90th $30–$1100%10%10th90th$54$1.0$5.0$20.0$100.0$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
$36.31 / $72.44 / $158.49
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$85.11 / $162.18 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $53.70 / $109.65
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$31.62 / $56.23 / $117.49
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $52.48 / $79.43
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$36.31 / $54.95 / $83.18
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $53.70 / $100.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $125.89 / $151.36
Cigna
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Cigna
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$33.88 / $33.88 / $33.88
Cigna
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$5.37 / $5.37 / $5.37
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $47.86 / $87.10
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $45.71 / $104.71
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $47.86 / $77.62
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $114.82
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $61.66 / $120.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $69.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $41.69 / $75.86
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$52.48 / $79.43 / $89.13
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $223.87
Wellcare
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Wellcare
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$22.39 / $22.39 / $22.39
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81