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North Carolina rates for HCPCS 99253

Inpatient or observation 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, 45 minutes must be met or exceeded.

Facilitymedian $162 · 10th–90th $112–$3240%10%20%10th90th$162Professionalmedian $145 · 10th–90th $85–$3090%5%10%10th90th$145$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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
$112.20 / $165.96 / $323.59
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $134.90 / $316.23
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $144.54 / $204.17
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $194.98 / $275.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $141.25 / $234.42
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $158.49 / $229.09
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $281.84
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $112.20 / $177.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $70.79
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $128.82 / $223.87
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95