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North Carolina rates for HCPCS 99213

Office or other outpatient visit for the evaluation and management of an established 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, 20 minutes must be met or exceeded.

Facilitymedian $93 · 10th–90th $52$2240%10%10th90th$93Professionalmedian $87 · 10th–90th $52$1860%10%10th90th$87$2.0$10.0$50.0$200.0$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
$47.86 / $102.33 / $229.09
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$89.13 / $158.49 / $309.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $85.11 / $186.21
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$52.48 / $87.10 / $194.98
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$257.04 / $263.03 / $269.15
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $85.11 / $128.82
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$69.18 / $91.20 / $134.90
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $95.50 / $162.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $125.89 / $151.36
Cigna
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Cigna
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
Cigna
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$10.23 / $10.23 / $10.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $81.28 / $147.91
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $75.86 / $169.82
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $81.28 / $125.89
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $186.21
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $107.15 / $194.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $69.18 / $117.49
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $91.20 / $141.25
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $630.96
Wellcare
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Wellcare
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$41.69 / $41.69 / $41.69
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $562.34