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North Carolina rates for HCPCS 99215

Office or other outpatient visit for the evaluation and management of an established 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, 40 minutes must be met or exceeded.

Facilitymedian $178 · 10th–90th $105–$3160%10%10th90th$178Professionalmedian $178 · 10th–90th $95–$3980%5%10%10th90th$178$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
$100.00 / $177.83 / $354.81
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$43.65 / $229.09 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $169.82 / $398.11
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$95.50 / $186.21 / $436.52
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $177.83 / $269.15
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$138.04 / $186.21 / $295.12
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $204.17 / $346.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $134.90 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $169.82 / $302.00
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $154.88 / $338.84
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $169.82 / $263.03
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $363.08
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $234.42 / $398.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $141.25 / $245.47
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $89.13 / $346.74
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $912.01
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,122.02