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Hospital Outpatient Clinic Visit

North Carolina rates for HCPCS G0463

Hospital outpatient clinic visit for assessment and management of a patient

Rates data updated July 2026.

How much does Hospital Outpatient Clinic Visit cost?

$166

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $166 for this service. The price depends on where it is billed: about $178 from a physician practice, and about $97.72 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$178$87.10 to $209
FacilityA hospital or hospital-owned outpatient department$97.72$83.18 to $195

How much rates vary

Facilitymedian $98 · 10th to 90th $47 to $437Professionalmedian $178 · 10th to 90th $72 to $209
$10$20$50$100$200$500facility $98professional $178

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
$30.20
Median
$97.72
Typical High
$489.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$87.10
Typical High
$120.23
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$66.07
BCBS
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$208.93
Typical High
$208.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$97.72
Medcost
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$87.10
Typical High
$134.90
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$79.43
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00

Where North Carolina sits

The same service costs 9.1 times more in North Carolina than in Minnesota. 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.

North Carolina· 1st of 51

$166

NC $166MN $18.20

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.