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Office Visit, Established Patient (Straightforward)

California 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 $45 · 10th–90th $29$1700%10%20%10th90th$45Professionalmedian $60 · 10th–90th $34$1550%10%20%10th90th$60$1.0$5.0$20.0$100.0$500.0$2.0K

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
$33.11
Median
$64.57
Typical High
$263.03
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$213.80
Typical High
$288.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$58.88
Typical High
$154.88
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$35.48
Median
$63.10
Typical High
$154.88
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$54.95
Typical High
$83.18
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$43.65
Median
$57.54
Typical High
$81.28
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$35.48
Typical High
$39.81
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$48.98
Typical High
$81.28
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$85.11
Typical High
$87.10
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$61.66
Typical High
$100.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$151.36
Typical High
$229.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$50.12
Typical High
$100.00
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$18.20
Median
$34.67
Typical High
$89.13
HealthNet
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$79.43
Typical High
$114.82
HealthNet
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$58.88
Typical High
$107.15
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$223.87
Typical High
$223.87
Lucent Health
Setting
Facility
Modifier
62 · Two surgeons
Typical Low
$141.25
Median
$141.25
Typical High
$141.25
Lucent Health
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$22.39
Median
$22.39
Typical High
$22.39
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$107.15
Typical High
$354.81
Molina
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$44.67
Typical High
$724.44
Optum
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$67.61
Typical High
$107.15
Providence
Setting
Facility
Modifier
Global
Typical Low
$27.54
Median
$47.86
Typical High
$85.11
Providence
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$52.48
Typical High
$112.20
Sutter Health Plus
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$66.07
Typical High
$120.23
The Alliance
Setting
Professional
Modifier
Global
Typical Low
$18.20
Median
$28.18
Typical High
$67.61
United
Setting
Facility
Modifier
Global
Typical Low
$38.02
Median
$46.77
Typical High
$75.86
United
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$42.66
Typical High
$91.20
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$52.48
Median
$79.43
Typical High
$89.13