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Initial hospital care, high complexity

CPT 99223 · negotiated-rate distribution across hospitals in SC

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Hospitals
4
Min
$33.6
Median
$42.8
Max
$166.44
Range multiplier
5.0×

By payer (49 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Medicaid176$71.33$71.33$167.42.3×
Blue Cross Blue Shield457$50$250.05$250.055.0×
Medicare144$163.7$166.44$205.091.3×
UnitedHealthcare439$13.1$166.44$220.0616.8×
no fault [114001]128$282.65$282.65$282.651.0×
Aetna426$29.1$50$194.016.7×
univera healthcare [100169]118$143.94$210.15$210.151.5×
Molina415$13.2$160.48$160.4812.2×
independent health [100165]114$179.85$179.85$179.851.0×
Cigna412$25.2$100.47$241.339.6×
WellCare110$174.76$174.76$183.081.0×
Humana49$13.2$174.76$174.7613.2×
fidelis essential [100163]16$183.08$183.08$183.081.0×
amerigroup [350102]16$71.33$71.33$71.331.0×
beacon essential [350122]16$149.8$199.73$199.731.3×
clover insurance company36$30$30$301.0×
federal workers compensation [500100]16$282.65$282.65$282.651.0×
independent health essential [100166]16$71.33$71.33$71.331.0×
mvp essential [100254]16$167.4$167.4$167.41.0×
TRICARE16$166.44$166.44$166.441.0×
univera healthcare essential [100170]16$143.94$143.94$143.941.0×
VA Health16$166.44$166.44$166.441.0×
iha first choice [800001]14$179.85$179.85$179.851.0×
devoted health24$25$25$251.0×
hospice [550001]14$166.44$166.44$166.441.0×
fidelis dual advantage [450120]14$174.76$174.76$174.761.0×
phcs33$90$90$901.0×
medcost - sc33$50.44$56.53$58.511.2×
Multiplan33$90$90$901.0×
plotkin health33$60$60$601.0×
select health33$13.2$19.84$25.341.9×
Self-Pay (Cash)33$50$50$501.0×
absolute total care33$13.86$20.83$26.611.9×
mvp mcd [350114]12$167.4$167.4$167.41.0×
covid19 hrsa [45013]12$166.44$166.44$166.441.0×
fallon health [450115]12$166.44$166.44$166.441.0×
excellus rochester mcd [350117]12$71.33$71.33$71.331.0×
fidelis exchange [100164]12$199.72$199.72$199.721.0×
ghi [100153]12$183.08$183.08$183.081.0×
seneca nation [450119]12$166.44$166.44$166.441.0×
beacon health options [100023]12$199.73$199.73$199.731.0×
tuscarora nation [550120]12$71.33$71.33$71.331.0×
champ va [700002]12$166.44$166.44$166.441.0×
catholic health life pace [400005]12$166.44$166.44$166.441.0×
devoted health plan12$25$25$251.0×
crime victims [100176]12$71.33$71.33$71.331.0×
vna option mltc [350110]12$71.33$71.33$71.331.0×
upmc health plan [100181]12$299.59$299.59$299.591.0×
mvp healthcare [100168]12$221.39$221.39$221.391.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
HILTON HEAD HOSPITALHILTON HEAD ISLANDSC15$16.3$42.8$194.01
EAST COOPER REGIONAL MEDICAL CENTERMT. PLEASANTSC15$18.72$36.9$194.01
COASTAL CAROLINA MEDICAL CENTERHARDEEVILLESC15$13.1$33.6$194.01
MARY BLACK MEMORIAL HOSPITALSPARTANBURGSC39$451.77$451.77$71.33$166.44$299.59

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.