# Office visit, existing patient (standard): what Blue Cross and Blue Shield of North Carolina pays, by state

The most common routine visit with a doctor you have seen before, about 20-30 minutes.

- Insurer: Blue Cross and Blue Shield of North Carolina
- Billing code: 99213 (Office visits)
- Price shown: negotiated in-network price, office, doctor's fee
- Prices as of: 2026-09-15
- All of the insurer's plans pooled; the map also shows single networks

| State | Providers | Named in files | Lowest | 25th pct | Median | 75th pct | Highest | Medicare pays | Median vs Medicare |
|---|---|---|---|---|---|---|---|---|---|
| Alabama | 126 | 318 | $43.00 | $94.12 | $97.97 | $127.18 | $221.18 | $87.79 | 1.1x Medicare |
| Alaska | 22 | 56 | $75.31 | $94.12 | $95.48 | $116.55 | $186.12 | $118.72 | 0.8x Medicare |
| Arizona | 134 | 371 | $33.39 | $94.12 | $105.89 | $130.17 | $221.18 | $93.25 | 1.1x Medicare |
| Arkansas | 40 | 111 | $43.00 | $94.12 | $108.29 | $130.02 | $221.18 | $86.86 | 1.2x Medicare |
| California | 407 | 1,237 | $43.00 | $94.12 | $116.03 | $145.34 | $221.18 | $104.31 | 1.1x Medicare |
| Colorado | 164 | 558 | $43.00 | $94.12 | $108.29 | $143.27 | $221.18 | $98.18 | 1.1x Medicare |
| Connecticut | 89 | 235 | $43.00 | $94.12 | $115.72 | $159.58 | $221.18 | $100.45 | 1.1x Medicare |
| Delaware | 22 | 66 | $43.00 | $94.12 | $108.29 | $124.91 | $165.94 | $94.52 | 1.1x Medicare |
| District of Columbia | 63 | 139 | $43.00 | $94.12 | $116.03 | $160.45 | $221.18 | $106.56 | 1.1x Medicare |
| Florida | 873 | 2,264 | $41.25 | $94.12 | $110.73 | $127.18 | $221.18 | $98.20 | 1.1x Medicare |
| Georgia | 610 | 1,424 | $43.00 | $94.12 | $94.12 | $124.07 | $221.18 | $93.60 | about what Medicare pays |
| Hawaii | 34 | 112 | $60.32 | $94.12 | $99.60 | $130.18 | $221.18 | $100.61 | about what Medicare pays |
| Idaho | 26 | 69 | $43.00 | $94.12 | $98.25 | $138.15 | $186.12 | $89.71 | 1.1x Medicare |
| Illinois | 230 | 589 | $41.25 | $94.12 | $113.25 | $146.54 | $221.18 | $96.44 | 1.2x Medicare |
| Indiana | 132 | 324 | $43.00 | $94.12 | $104.77 | $143.27 | $221.18 | $90.09 | 1.2x Medicare |
| Iowa | 43 | 99 | $43.00 | $94.12 | $127.18 | $169.84 | $221.18 | $89.23 | 1.4x Medicare |
| Kansas | 46 | 107 | $54.96 | $94.12 | $104.27 | $141.42 | $221.18 | $89.02 | 1.2x Medicare |
| Kentucky | 136 | 307 | $43.00 | $94.12 | $99.60 | $130.17 | $221.18 | $89.52 | 1.1x Medicare |
| Louisiana | 73 | 196 | $43.00 | $94.12 | $113.61 | $147.57 | $221.18 | $91.09 | 1.2x Medicare |
| Maine | 57 | 118 | $43.00 | $94.12 | $94.12 | $131.71 | $221.18 | $91.90 | about what Medicare pays |
| Maryland | 213 | 529 | $39.25 | $94.12 | $113.61 | $147.57 | $221.18 | $98.07 | 1.2x Medicare |
| Massachusetts | 191 | 495 | $40.71 | $94.12 | $135.09 | $170.14 | $221.18 | $101.98 | 1.3x Medicare |
| Michigan | 212 | 532 | $43.00 | $94.12 | $115.72 | $147.96 | $221.18 | $93.45 | 1.2x Medicare |
| Minnesota | 103 | 305 | $41.25 | $94.12 | $116.55 | $152.31 | $221.18 | $94.49 | 1.2x Medicare |
| Mississippi | 35 | 100 | $43.00 | $94.12 | $94.12 | $136.60 | $191.41 | $87.63 | 1.1x Medicare |
| Missouri | 102 | 285 | $51.59 | $94.12 | $111.62 | $149.17 | $221.18 | $91.13 | 1.2x Medicare |
| Montana | 29 | 68 | $43.00 | $94.12 | $118.09 | $147.57 | $179.13 | $95.19 | 1.2x Medicare |
| Nebraska | 28 | 73 | $43.00 | $94.12 | $94.12 | $137.40 | $221.18 | $89.57 | about what Medicare pays |
| Nevada | 43 | 124 | $43.00 | $94.12 | $117.32 | $142.65 | $221.18 | $94.74 | 1.2x Medicare |
| New Hampshire | 44 | 121 | $43.00 | $94.12 | $104.45 | $135.84 | $221.18 | $96.82 | 1.1x Medicare |
| New Jersey | 132 | 389 | $43.00 | $94.12 | $116.03 | $150.71 | $221.18 | $103.82 | 1.1x Medicare |
| New Mexico | 37 | 95 | $43.00 | $94.12 | $113.61 | $138.22 | $221.18 | $91.75 | 1.2x Medicare |
| New York | 479 | 1,187 | $41.25 | $94.12 | $116.03 | $147.65 | $221.18 | $103.97 | 1.1x Medicare |
| North Carolina | 38,869 | 83,735 | $33.39 | $94.12 | $116.03 | $149.17 | $221.18 | $90.84 | 1.3x Medicare |
| North Dakota | 9 | 26 | $91.58 | $94.12 | $115.72 | $131.20 | $186.12 | $93.41 | 1.2x Medicare |
| Ohio | 351 | 848 | $43.00 | $94.12 | $113.61 | $138.35 | $221.18 | $90.97 | 1.2x Medicare |
| Oklahoma | 42 | 115 | $65.35 | $94.12 | $94.12 | $116.55 | $221.18 | $89.30 | about what Medicare pays |
| Oregon | 94 | 222 | $41.25 | $94.12 | $114.49 | $147.57 | $221.18 | $97.32 | 1.2x Medicare |
| Pennsylvania | 391 | 916 | $39.25 | $94.12 | $113.61 | $143.21 | $221.18 | $94.79 | 1.2x Medicare |
| Puerto Rico | 12 | 33 | $77.27 | $94.12 | $94.12 | $124.65 | $186.12 | $95.68 | about what Medicare pays |
| Rhode Island | 36 | 75 | $60.32 | $94.12 | $99.60 | $127.18 | $221.18 | $97.30 | about what Medicare pays |
| South Carolina | 1,508 | 3,240 | $43.00 | $94.12 | $94.12 | $127.18 | $221.18 | $91.04 | about what Medicare pays |
| South Dakota | 10 | 25 | $77.27 | $94.12 | $113.61 | $153.35 | $221.18 | $93.20 | 1.2x Medicare |
| Tennessee | 456 | 1,011 | $43.00 | $94.12 | $94.12 | $128.81 | $221.18 | $89.36 | about what Medicare pays |
| Texas | 393 | 1,199 | $41.25 | $94.12 | $108.29 | $143.27 | $221.18 | $94.46 | 1.1x Medicare |
| U.S. Virgin Islands | 2 | 4 | $94.12 | $113.61 | $127.18 | $128.33 | $135.09 | $95.68 | 1.3x Medicare |
| Utah | 36 | 137 | $43.00 | $94.12 | $128.00 | $169.84 | $221.18 | $91.96 | 1.4x Medicare |
| Vermont | 10 | 30 | $60.32 | $94.12 | $106.77 | $147.84 | $221.18 | $93.22 | 1.1x Medicare |
| Virginia | 899 | 1,997 | $43.00 | $94.12 | $99.60 | $138.35 | $221.18 | $93.48 | 1.1x Medicare |
| Washington | 125 | 362 | $43.00 | $94.12 | $117.32 | $152.36 | $221.18 | $102.75 | 1.1x Medicare |
| West Virginia | 91 | 204 | $43.00 | $94.12 | $108.29 | $143.27 | $221.18 | $90.10 | 1.2x Medicare |
| Wisconsin | 100 | 239 | $43.00 | $94.12 | $115.72 | $147.57 | $221.18 | $91.06 | 1.3x Medicare |
| Wyoming | 11 | 27 | $77.27 | $94.12 | $105.46 | $123.77 | $169.84 | $94.41 | 1.1x Medicare |

**“x Medicare”** compares each price with what original Medicare pays a doctor for the same service in the same state under its physician fee schedule (RVU26D, in force from 2026-10-01) — the price for a doctor's own office. Insurers write their contracts as a share of Medicare, so 1.3x means the insurer pays 30% more than Medicare would; Medicare Advantage plans generally pay close to 1.0x.

Blue Cross and Blue Shield of North Carolina’s files name **107,448 providers** for this procedure; **48,420** are counted here: the clinicians whose specialty performs it and the practices, clinics and hospitals. Insurers attach their whole fee schedule to every contracted provider, so the rest are clinicians listed at a price for something they never do; counting them would inflate the provider count and pull the typical price towards the fee schedule’s floor.

Prices are what the insurer has agreed to pay, not what you will be billed. This is a statewide summary: prices vary far more between towns and between practices than these medians suggest, and "providers" counts everyone with a contracted price, not only those who perform the procedure.

Map: https://medicalpricetransparency.netlify.app/insurers/bcbsnc/statemap_99213_US.html  
About this insurer's data, and its other procedures: [index.md](index.md)