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Specialist Consultation For A Hospitalized Patient

South Carolina rates for HCPCS 99253

This covers an initial evaluation of a hospitalized patient by a specialist at the request of another treating doctor, seeking advice or a second opinion on the patient's care. It involves a detailed review of the patient's history and a physical exam, along with medical decision-making of low complexity. The requesting doctor remains involved in the patient's care alongside the consulting specialist.

Rates data updated July 2026.

How much does Specialist Consultation For A Hospitalized Patient cost?

$123

Typical physician fee. In South Carolina, July 2026.

Insurers have agreed to pay about $123 for this service. Most negotiated rates run $95.50 to $170.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $110 · 10th to 90th $81 to $191Professionalmedian $126 · 10th to 90th $81 to $288
$100$200facility $110professional $126

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$93.33
Typical High
$109.65
Aetna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$125.89
Typical High
$288.40
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$109.65
BCBS
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$117.49
Typical High
$141.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$125.89
Typical High
$218.78
Medcost
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
Medcost
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$147.91
Typical High
$234.42
Molina
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$93.33
Typical High
$120.23
United
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$114.82
Typical High
$190.55

Where South Carolina sits

The same service costs 2.2 times more in South Dakota than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Carolina· 38th of 51

$123

SD $209DC $95.50

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.