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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 July 2026.

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

$42.66

Typical negotiated rate. In Alabama, July 2026.

Insurers have agreed to pay about $42.66 for this service. The price depends on where it is billed: about $42.66 from a physician practice, and about $33.88 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$42.66$33.11 to $52.48
FacilityA hospital or hospital-owned outpatient department$33.88$24.55 to $45.71

How much rates vary

Facilitymedian $34 · 10th to 90th $21 to $87Professionalmedian $43 · 10th to 90th $25 to $72
$20$50$100facility $34professional $43

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$21.38
Median
$33.88
Typical High
$75.86
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$724.44
Median
$724.44
Typical High
$724.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$42.66
Typical High
$72.44
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$34.67
Median
$56.23
Typical High
$89.13
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$53.70
Typical High
$75.86
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$41.69
Median
$54.95
Typical High
$75.86
BCBS
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$57.54
Typical High
$102.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$134.90
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$42.66
Typical High
$87.10
United
Setting
Facility
Modifier
Global
Typical Low
$32.36
Median
$69.18
Typical High
$120.23
United
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$37.15
Typical High
$69.18
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$67.61
Median
$70.79
Typical High
$89.13

Where Alabama sits

The same service costs 1.6 times more in Minnesota than in Washington, DC. 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· 47th of 51

$42.66

MN $63.10DC $38.90

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.