New Patient Office Or Other Outpatient Visit, 45-59 Minutes in South Carolina
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
Top Providers in South Carolina
| Provider | Medicare | Services |
|---|---|---|
| Griffin, Neil MD | $111.15 | 812 |
| Maurer, David M.D. | $111.35 | 616 |
| Crosby, Christopher DPM | $112.49 | 600 |
| Seltzer, Samuel MD | $104.13 | 545 |
| Vroman, David MD | $110.82 | 508 |
| Lencke, Mark M.D. | $113.85 | 475 |
| Boatright, Karl MD | $117.55 | 470 |
| Reuben, Jeffery | $119.06 | 464 |
| Winebrenner, Derek PA-C | $92.33 | 458 |
South Carolina Pricing in Context
In South Carolina, CPT code 99204 (New Patient Office Or Other Outpatient Visit, 45-59 Minutes) carries an average Medicare payment of $104.98 — 6% below the national benchmark of $111.40. 8.8K providers across the state submitted claims for this procedure in 2023, performing 288.3K total services. Individual payments in SC ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.
The average billed charge in South Carolina is $327.00, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because South Carolina sits below the national Medicare average, commercial rates in the state may also run lower than the US median.
Using RAND 2024 commercial-to-Medicare ratios for Office Visit procedures, the estimated commercial insurance price in South Carolina lands near $351.91, with self-pay cash prices typically around $202.24. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.
Frequently Asked Questions
How much does New Patient Office Or Other Outpatient Visit, 45-59 Minutes cost in South Carolina?
The average Medicare payment for New Patient Office Or Other Outpatient Visit, 45-59 Minutes in South Carolina is $104.98, which is 6% below the national average of $111.40. Providers in SC typically bill $327.00 for this procedure.
What does New Patient Office Or Other Outpatient Visit, 45-59 Minutes cost with insurance in South Carolina?
With commercial insurance in South Carolina, New Patient Office Or Other Outpatient Visit, 45-59 Minutes costs an estimated $351.91. Without insurance, the estimated cash price is $202.24. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.
How many providers perform New Patient Office Or Other Outpatient Visit, 45-59 Minutes in South Carolina?
8.8K providers in South Carolina billed Medicare for New Patient Office Or Other Outpatient Visit, 45-59 Minutes in 2023, performing 288.3K total services. Medicare payments ranged from N/A to N/A depending on the provider.
Is New Patient Office Or Other Outpatient Visit, 45-59 Minutes cheaper in South Carolina than the national average?
Yes — New Patient Office Or Other Outpatient Visit, 45-59 Minutes costs 6% below the national average in South Carolina. The state average Medicare payment is $104.98 compared to $111.40 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.
Related Guides
Related Data Sources
Data from CMS Medicare Physician & Other Practitioners (2023).
Read our methodology — how this data is sourced, computed, and verified.