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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
$92.03 / $92.03 / $92.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.03 / $92.03 / $102.49
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.00 / $54.00 / $91.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.14 / $97.71 / $126.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.03 / $109.16 / $109.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.90 / $86.90 / $86.90
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.03 / $94.03 / $124.24
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.11 / $94.03 / $140.72
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.06 / $148.13 / $176.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.17 / $99.90 / $175.97
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.77 / $498.64 / $498.64
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$599.65 / $802.58 / $802.58