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South Carolina rates for HCPCS 99243

Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.

Facilitymedian $138 · 10th–90th $91–$2140%10%10th90th$138Professionalmedian $110 · 10th–90th $72–$2000%10%10th90th$110$5.0$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
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $109.65 / $199.53
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $112.20 / $208.93
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $117.49 / $138.04
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $125.89 / $199.53
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $147.91 / $181.97
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $138.04 / $213.80
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $83.18 / $117.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $112.20 / $173.78