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North Carolina rates for HCPCS 99214

Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate 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 $126 · 10th–90th $48–$2510%5%10%10th90th$126Professionalmedian $120 · 10th–90th $59–$2750%5%10%10th90th$120$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
$45.71 / $125.89 / $263.03
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$43.65 / $194.98 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $117.49 / $275.42
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$60.26 / $123.03 / $302.00
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$95.50 / $95.50 / $234.42
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $120.23 / $186.21
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$91.20 / $128.82 / $190.55
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $144.54 / $239.88
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
$77.62 / $120.23 / $213.80
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $114.82 / $239.88
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $120.23 / $186.21
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $269.15
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $154.88 / $281.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $120.23 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $102.33 / $173.78
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $89.13 / $181.97
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $630.96
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33