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South 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 $76 · 10th–90th $49–$1820%10%10th90th$76Professionalmedian $83 · 10th–90th $48–$1860%10%10th90th$83$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
$48.98 / $74.13 / $251.19
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$47.86 / $134.90 / $257.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $79.43 / $177.83
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$52.48 / $87.10 / $194.98
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $85.11 / $134.90
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$58.88 / $89.13 / $134.90
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.60 / $109.65 / $257.04
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $52.48 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $102.33 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $74.13 / $128.82
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $75.86 / $79.43
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $77.62 / $125.89
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $39.81
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $181.97
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $63.10 / $107.15
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $89.13 / $154.88