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North Carolina rates for HCPCS 99242

Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.82 / $248.86 / $248.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.95 / $92.70 / $181.51
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.48 / $120.51 / $120.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.22 / $138.13 / $199.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.68 / $73.68 / $73.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.23 / $106.08 / $175.06
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.87 / $102.55 / $179.16
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.00 / $110.00 / $126.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.57 / $96.32 / $165.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.70 / $98.54 / $165.00
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$272.83 / $272.83 / $272.83
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$414.94 / $554.37 / $554.37