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Office visit, new patient, 60-74 min

CPT 99205 · negotiated-rate distribution across hospitals in SC

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Hospitals
16
Min
$30.00
Median
$35.70
Max
$212.68
Range multiplier
7.1×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield596$14.70$253.29$291.1619.8×
Medicaid174$156.73$195.47$212.681.4×
Medicare145$174.14$212.68$223.321.3×
UnitedHealthcare541$10.90$206.30$224.0320.6×
Aetna535$29.10$58.80$212.687.3×
no fault [114001]128$221.13$221.13$221.131.0×
univera healthcare [100169]118$173.20$237.35$237.351.4×
Molina415$13.20$439.81$439.8133.3×
Cigna515$25.20$67.70$308.3912.2×
independent health [100165]114$229.82$229.82$229.821.0×
Humana511$13.20$212.68$212.6816.1×
WellCare110$223.32$223.32$233.951.0×
federal workers compensation [500100]19$174.14$221.13$221.131.3×
independent health essential [100166]16$195.47$195.47$195.471.0×
amerigroup [350102]16$195.47$195.47$195.471.0×
beacon essential [350122]16$156.73$208.97$208.971.3×
clover insurance company36$30.00$30.00$30.001.0×
fidelis essential [100163]16$191.41$255.22$255.221.3×
hospice [550001]16$174.14$212.68$212.681.2×
TRICARE16$212.68$212.68$212.681.0×
univera healthcare essential [100170]16$173.20$173.20$173.201.0×
VA Health16$212.68$212.68$212.681.0×
absolute total care45$13.86$18.00$26.611.9×
fidelis dual advantage [450120]14$223.32$223.32$223.321.0×
devoted health24$25.00$25.00$25.001.0×
iha first choice [800001]14$229.82$229.82$229.821.0×
Multiplan44$85.00$90.00$90.001.1×
select health33$13.20$19.84$25.341.9×
plotkin health33$60.00$60.00$60.001.0×
medcost - sc33$50.44$56.53$58.511.2×
phcs33$90.00$90.00$90.001.0×
champ va [700002]12$212.68$212.68$212.681.0×
upmc health plan [100181]12$200.56$200.56$200.561.0×
fidelis exchange [100164]12$255.22$255.22$255.221.0×
ghi [100153]12$233.95$233.95$233.951.0×
devoted health plan12$25.00$25.00$25.001.0×
magnacare [100142]12$212.68$212.68$212.681.0×
medcost12$56.90$65.30$73.701.3×
crime victims [100176]12$195.47$195.47$195.471.0×
covid19 hrsa [45013]12$212.68$212.68$212.681.0×
Meritain Health12$212.68$212.68$212.681.0×
mvp healthcare [100168]12$225.39$225.39$225.391.0×
catholic health life pace [400005]12$212.68$212.68$212.681.0×
seneca nation [450119]12$212.68$212.68$212.681.0×
vna option mltc [350110]12$195.47$195.47$195.471.0×
tuscarora nation [550120]12$195.47$195.47$195.471.0×
beacon health options [100023]12$208.97$208.97$208.971.0×
excellus rochester mcd [350117]12$195.47$195.47$195.471.0×
fallon health [450115]12$212.68$212.68$212.681.0×
prime health11$85.00$85.00$85.001.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Colleton Medical CenterWalterboroSC24$2,808.00$2,808.00$15.20$67.70$414.50
East Cooper Regional Medical CenterMt. PleasantSC14$255.41$18.80$35.70$255.41
Hilton Head HospitalHilton Head IslandSC14$255.41$13.60$31.40$255.41
Coastal Carolina Medical CenterHardeevilleSC14$255.41$10.90$30.00$255.41
Mary Black Memorial HospitalSpartanburgSC39$462.00$462.00$108.35$212.68$439.81
Roper St. Francis Mt Pleasant HospitMt. PleasantSC0$802.00$521.30
Mcleod Loris Seacoast HospitalLorisSC0$999.00$709.29
Mcleod Health CherawCherawSC0$999.00$709.29
Mcleod Health ClarendonManningSC0$999.00$709.29
Roper St. Francis Hospital-BerkeleySummervilleSC0$387.00$251.55
Mcleod Medical Center - DillonDillonSC0$999.00$709.29
Edgefield County HealthcareEdgefieldSC0$500.17$300.10
Mcleod Regional Medical CenterFlorenceSC0$999.00$709.29
Bon Secours St. Francis Xavier HospiCharlestonSC0$802.00$521.30
Self Regional HealthcareGreenwoodSC0$500.17$300.10
Roper Hospital Inc.CharlestonSC0$387.00$251.55

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.