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North Carolina rates for HCPCS G2025

Payment for a telehealth distant site service furnished by a Rural Health Clinic (RHC) or Federally Qualified Health Center (FQHC) only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.20 / $91.20 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $93.33 / $109.65
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $87.10 / $112.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $100.00 / $134.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.20 / $151.36 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $87.10
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.20 / $102.33 / $169.82
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $44.67 / $44.67
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $194.98 / $218.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $100.00 / $158.49
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $602.56 / $602.56
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $794.33 / $794.33