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North Carolina rates for HCPCS 99234

Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.

Facilitymedian $178 · 10th–90th $19–$3720%10%10th90th$178Professionalmedian $166 · 10th–90th $166–$1660%50%100%$166$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $190.55 / $371.54
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$9.55 / $19.05 / $204.17
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $165.96
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $169.82 / $269.15
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33