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North Carolina rates for HCPCS 99232

Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a 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, 35 minutes must be met or exceeded.

Facilitymedian $105 · 10th–90th $69–$2040%10%10th90th$105Professionalmedian $81 · 10th–90th $58–$1820%10%10th90th$81$10.0$20.0$50.0$100.0$200.0$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
$69.18 / $104.71 / $204.17
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $79.43 / $186.21
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $91.20 / $123.03
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $112.20 / $169.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Cigna
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
Cigna
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$12.30 / $12.30 / $12.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $91.20 / $151.36
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $100.00 / $154.88
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $173.78
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $123.03 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $83.18 / $141.25
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $436.52
Wellcare
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$43.65 / $43.65 / $43.65
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $457.09