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Office Visit, Established Patient (Straightforward)

Nationwide rates for HCPCS 99212

A brief follow-up appointment with a doctor or other provider the patient has seen before, used for simple, low-complexity issues that don't require much evaluation or decision-making. It's the most basic level of an established-patient office visit, often used for minor concerns or quick check-ins. Visit length and content are limited compared to visits addressing more involved problems.

Rates data updated July 2026.

Facilitymedian $52 · 10th–90th $28$2090%10%10th90th$52Professionalmedian $51 · 10th–90th $28$1120%10%10th90th$51$0.1$1.0$10.0$100.0$1.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$28.18
Median
$57.54
Typical High
$245.47
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$58.88
Median
$141.25
Typical High
$416.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$48.98
Typical High
$107.15
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$34.67
Median
$60.26
Typical High
$120.23
Aetna
Setting
Professional
Modifier
50 · Both sides
Typical Low
$47.86
Median
$47.86
Typical High
$47.86
BCBS
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$35.48
Typical High
$46.77
BCBS
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$42.66
Typical High
$79.43
BCBS
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$34.67
Median
$34.67
Typical High
$34.67
Cigna
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$128.82
Typical High
$199.53
Cigna
Setting
Facility
Modifier
22 · Increased work
Typical Low
$60.26
Median
$60.26
Typical High
$60.26
Cigna
Setting
Facility
Modifier
62 · Two surgeons
Typical Low
$31.62
Median
$31.62
Typical High
$31.62
Cigna
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$5.01
Median
$5.01
Typical High
$5.01
Cigna
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$50.12
Typical High
$100.00
United
Setting
Facility
Modifier
Global
Typical Low
$33.11
Median
$53.70
Typical High
$141.25
United
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$51.29
Typical High
$112.20
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$52.48
Median
$79.43
Typical High
$100.00