97116 · North Carolina · every payer
What every payer pays for 97116 in North Carolina
Across 12 commercial payers in North Carolina, the middle payer's median for 97116 (physician and practitioner services (fee schedule)) is $27.14 per 15 min. North Carolina Medicaid's fee-for-service rate, $20.05 per 15 min, is 26% below that commercial median.
- Commercial median
- $27.14per 15 min
- North Carolina Medicaid
- $20.05
- Medicare
- $28.02
On this page
Payer mix
97116 in North Carolina, by payer type
Medicare's physician fee schedule pays $28.02 in North Carolina.
By payer
Each payer's 97116 rate in North Carolina
FAQ
Frequently asked questions
What do commercial payers pay for 97116 in North Carolina?
The median of 12 payers' medians is $27.14 per 15 min, from 340 published rates in the October 2026 files.
How does North Carolina Medicaid compare with commercial insurance for 97116?
North Carolina Medicaid pays $20.05 per 15 min, 26% below the commercial median.
What does Medicare pay for 97116 in North Carolina?
$28.02 on the RVU26B physician fee schedule (non-facility).
What does UnitedHealthcare pay for 97116 in North Carolina?
UnitedHealthcare's median is $27.57 per 15 min, from 151 rates and 513 providers.
What does Aetna pay for 97116 in North Carolina?
Aetna's median is $24.64 per 15 min, from 77 rates and 1115 providers.