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Office Visit, Established Patient (Straightforward)

Colorado 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?

$43.65

Typical negotiated rate. In Colorado, July 2026.

Insurers have agreed to pay about $43.65 for this service. The price depends on where it is billed: about $43.65 from a physician practice, and about $53.70 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 7 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$43.65$33.11 to $57.54
FacilityA hospital or hospital-owned outpatient department$53.70$38.02 to $77.62

How much rates vary

Facilitymedian $54 · 10th to 90th $30 to $126Professionalmedian $44 · 10th to 90th $25 to $89
$1.0$5.0$20.0$100.0facility $54professional $44

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
$33.88
Median
$83.18
Typical High
$208.93
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$93.33
Median
$181.97
Typical High
$257.04
Aetna
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$43.65
Typical High
$89.13
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$33.88
Median
$58.88
Typical High
$120.23
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$38.90
Median
$38.90
Typical High
$38.90
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$53.70
Typical High
$91.20
Anthem 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
$74.13
Median
$147.91
Typical High
$190.55
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
$31.62
Median
$51.29
Typical High
$89.13
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$29.51
Median
$48.98
Typical High
$83.18
Denver HMP
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$31.62
Typical High
$31.62
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$85.11
Typical High
$147.91
Select Health
Setting
Facility
Modifier
Global
Typical Low
$43.65
Median
$43.65
Typical High
$43.65
Select Health
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$42.66
Typical High
$61.66
United
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$151.36
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$51.29
Typical High
$95.50
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$52.48
Median
$85.11
Typical High
$100.00

Where Colorado sits

The same service costs 1.6 times more in Minnesota than in Washington, DC. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Colorado $43.65 · 42nd of 51
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.