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Office Visit, Established Patient (Straightforward)

Alabama 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 October 2026.

How much does Office Visit, Established Patient (Straightforward) cost?

$33.88

Typical physician fee. In Alabama, October 2026.

Insurers have agreed to pay about $33.88 for this service. Most negotiated rates run $24.55 to $42.66.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $39 · 10th to 90th $24 to $141Professionalmedian $34 · 10th to 90th $21 to $48
$20$50$100facility $39professional $34

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$21.38
Median
$33.88
Typical High
$45.71
Aetna
Setting
Professional
Modifier
None
Typical Low
$21.38
Median
$33.88
Typical High
$45.71
Ambetter
Setting
Professional
Modifier
None
Typical Low
$25.12
Median
$45.71
Typical High
$56.23
BCBS Alabama
Setting
Professional
Modifier
None
Typical Low
$33.11
Median
$75.86
Typical High
$120.23
Cigna
Setting
Facility
Modifier
None
Typical Low
$114.82
Median
$134.90
Typical High
$151.36
Cigna
Setting
Professional
Modifier
None
Typical Low
$21.38
Median
$35.48
Typical High
$40.74
United
Setting
Professional
Modifier
None
Typical Low
$19.95
Median
$31.62
Typical High
$48.98
7 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$14.45
Median
$17.78
Typical High
$22.39
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$4.37
Median
$5.37
Typical High
$6.76
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$2.88
Median
$3.55
Typical High
$4.57
Ambetter
Setting
Professional
Modifier
24 · Unrelated visit after surgery
Typical Low
$35.48
Median
$53.70
Typical High
$70.79
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$43.65
Median
$48.98
Typical High
$57.54
Ambetter
Setting
Professional
Modifier
93 · Audio-only telehealth
Typical Low
$25.12
Median
$25.12
Typical High
$33.88
BCBS Alabama
Setting
Professional
Modifier
10
Typical Low
$32.36
Median
$44.67
Typical High
$64.57

Where Alabama sits

The same service costs 2.4 times more in Alaska than in New Jersey. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Alabama· 50th of 51

$33.88

AK $77.62NJ $32.36

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.