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South Carolina rates for HCPCS 99254

Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.

Facilitymedian $155 · 10th–90th $120–$2690%20%10th90th$155Professionalmedian $170 · 10th–90th $115–$4170%10%10th90th$170$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 / $151.36 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $169.82 / $416.87
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $169.82 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $186.21 / $331.13
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $204.17 / $309.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $125.89 / $173.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $165.96 / $275.42