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Prolonged Office or Outpatient Visit, Additional 15 Minutes

North Carolina rates for HCPCS G2212

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified health care professional, with or without direct patient contact (list separately in addition to CPT codes 99205, 99215, 99483 for office or other outpatient evaluation and management services.) (Do not report G2212 on the same date of service as codes 99358, 99359, 99415, 99416). (Do not report G2212 for any time unit less than 15 minutes)

Rates data updated July 2026.

How much does Prolonged Office or Outpatient Visit, Additional 15 Minutes cost?

$37.15

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $37.15 for this service. The price depends on where it is billed: about $37.15 from a physician practice, and about $34.67 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 8 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$37.15$30.90 to $53.70
FacilityA hospital or hospital-owned outpatient department$34.67$30.90 to $41.69

How much rates vary

Facilitymedian $35 · 10th to 90th $28 to $55Professionalmedian $37 · 10th to 90th $26 to $76
$10$20$50$100facility $35professional $37

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
$30.90
Median
$32.36
Typical High
$50.12
Aetna
Setting
Professional
Modifier
Global
Typical Low
$18.20
Median
$30.90
Typical High
$50.12
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$28.84
Median
$52.48
Typical High
$158.49
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$33.11
Typical High
$47.86
BCBS
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$45.71
Typical High
$75.86
Cigna
Setting
Facility
Modifier
Global
Typical Low
$38.02
Median
$38.02
Typical High
$38.02
Cigna
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$31.62
Typical High
$31.62
Medcost
Setting
Facility
Modifier
Global
Typical Low
$28.18
Median
$34.67
Typical High
$53.70
Medcost
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$28.84
Typical High
$81.28
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$36.31
Typical High
$64.57
United
Setting
Facility
Modifier
Global
Typical Low
$38.02
Median
$38.02
Typical High
$52.48
United
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$36.31
Typical High
$61.66
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$263.03
Typical High
$263.03

Where North Carolina sits

The same service costs 1.7 times more in Minnesota than in Texas. 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· 5th of 51

$37.15

MN $50.12TX $28.84

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.