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Observation Care Admission, High Complexity

North Carolina rates for HCPCS 99220

The doctor's first full assessment when you are placed under observation in hospital, for someone who is seriously unwell or unstable. It covers a comprehensive history and examination and complex decision-making, often with several tests and treatments started at the same time.

Rates data updated July 2026.

How much does Observation Care Admission, High Complexity cost?

$851

Typical physician fee. In North Carolina, July 2026.

Insurers have agreed to pay about $851 for this service. Most negotiated rates run $851 to $851.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $603 · 10th to 90th $603 to $603Professionalmedian $851 · 10th to 90th $89 to $851
$100$200$500facility $603professional $851

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Medcost
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$87.10
Typical High
$229.09
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$602.56
Typical High
$602.56
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$851.14
Typical High
$851.14

Where North Carolina sits

The same service costs 28.2 times more in Massachusetts than in South Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

North Carolina· 3rd of 50

$851

MA $851SC $30.20

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.