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North Carolina rates for HCPCS 99251

Inpatient consultation for a new or established patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 20 minutes are spent at the bedside and on the patient's hospital floor or unit.

Facilitymedian $200 · 10th–90th $37–$2000%50%10th$200Professionalmedian $74 · 10th–90th $46–$5010%20%10th90th$74$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
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $223.87
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$37.15 / $37.15 / $37.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $61.66 / $87.10
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $501.19