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North Carolina rates for HCPCS 99354

Prolonged service(s) in the outpatient setting requiring direct patient contact beyond the time of the usual service; first hour (List separately in addition to code for outpatient Evaluation and Management or psychotherapy service, except with office or other outpatient services [99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215])

Facilitymedian $372 · 10th–90th $372–$3720%50%$372Professionalmedian $132 · 10th–90th $89–$7760%10%10th90th$132$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
$131.83 / $131.83 / $138.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $457.09 / $588.84
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $120.23 / $234.42
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $173.78 / $245.47
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $123.03 / $190.55
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $371.54
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $776.25