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Office visit, new patient, 45-59 min

CPT 99204 · negotiated-rate distribution across hospitals in SC

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Hospitals
16
Min
$30
Median
$35.7
Max
$161.26
Range multiplier
5.4×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield596$14.7$186.31$224.2515.3×
Medicaid174$115.28$147.88$161.261.4×
Medicare145$128.09$161.26$169.321.3×
UnitedHealthcare541$10.9$156.42$177.1816.3×
Aetna535$29.1$58.8$161.265.5×
no fault [114001]128$163.85$163.85$163.851.0×
univera healthcare [100169]118$131.19$179.78$179.781.4×
Molina415$13.2$332.73$332.7325.2×
Cigna515$25.2$67.7$233.839.3×
independent health [100165]114$174.26$174.26$174.261.0×
Humana511$13.2$161.26$161.2612.2×
WellCare110$169.32$169.32$177.391.0×
federal workers compensation [500100]19$128.09$163.85$163.851.3×
independent health essential [100166]16$147.88$147.88$147.881.0×
amerigroup [350102]16$147.88$147.88$147.881.0×
beacon essential [350122]16$115.28$153.71$153.711.3×
clover insurance company36$30$30$301.0×
fidelis essential [100163]16$145.14$193.51$193.511.3×
hospice [550001]16$128.09$161.26$161.261.3×
TRICARE16$161.26$161.26$161.261.0×
univera healthcare essential [100170]16$131.19$131.19$131.191.0×
VA Health16$161.26$161.26$161.261.0×
absolute total care45$13.86$18$26.611.9×
fidelis dual advantage [450120]14$169.32$169.32$169.321.0×
devoted health24$25$25$251.0×
iha first choice [800001]14$174.26$174.26$174.261.0×
Multiplan44$85$90$901.1×
select health33$13.2$19.84$25.341.9×
plotkin health33$60$60$601.0×
medcost - sc33$50.44$56.53$58.511.2×
phcs33$90$90$901.0×
champ va [700002]12$161.26$161.26$161.261.0×
upmc health plan [100181]12$160.49$160.49$160.491.0×
fidelis exchange [100164]12$193.51$193.51$193.511.0×
ghi [100153]12$177.39$177.39$177.391.0×
devoted health plan12$25$25$251.0×
magnacare [100142]12$161.26$161.26$161.261.0×
medcost12$56.9$65.3$73.71.3×
crime victims [100176]12$147.88$147.88$147.881.0×
covid19 hrsa [45013]12$161.26$161.26$161.261.0×
Meritain Health12$161.26$161.26$161.261.0×
mvp healthcare [100168]12$178.25$178.25$178.251.0×
catholic health life pace [400005]12$161.26$161.26$161.261.0×
seneca nation [450119]12$161.26$161.26$161.261.0×
vna option mltc [350110]12$147.88$147.88$147.881.0×
tuscarora nation [550120]12$147.88$147.88$147.881.0×
beacon health options [100023]12$153.71$153.71$153.711.0×
excellus rochester mcd [350117]12$147.88$147.88$147.881.0×
fallon health [450115]12$161.26$161.26$161.261.0×
prime health11$85$85$851.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
COLLETON MEDICAL CENTERWALTERBOROSC24$1,828$1,828$15.2$67.7$292.52
EAST COOPER REGIONAL MEDICAL CENTERMT. PLEASANTSC14$188.7$18.8$35.7$188.7
HILTON HEAD HOSPITALHILTON HEAD ISLANDSC14$188.7$13.6$31.4$188.7
COASTAL CAROLINA MEDICAL CENTERHARDEEVILLESC14$188.7$10.9$30$188.7
MARY BLACK MEMORIAL HOSPITALSPARTANBURGSC39$350$350$86.41$161.26$332.73
ROPER ST. FRANCIS MT PLEASANT HOSPITMT. PLEASANTSC0$654$425.1
MCLEOD LORIS SEACOAST HOSPITALLORISSC0$697$494.87
MCLEOD HEALTH CHERAWCHERAWSC0$697$494.87
MCLEOD HEALTH CLARENDONMANNINGSC0$697$494.87
ROPER ST. FRANCIS HOSPITAL-BERKELEYSUMMERVILLESC0$344$223.6
MCLEOD MEDICAL CENTER - DILLONDILLONSC0$697$494.87
EDGEFIELD COUNTY HEALTHCAREEDGEFIELDSC0$332.32$199.39
MCLEOD REGIONAL MEDICAL CENTERFLORENCESC0$697$494.87
BON SECOURS ST. FRANCIS XAVIER HOSPICHARLESTONSC0$654$425.1
SELF REGIONAL HEALTHCAREGREENWOODSC0$332.32$199.39
ROPER HOSPITAL INC.CHARLESTONSC0$344$223.6

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.