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Office Visit, Established Patient (Straightforward)

Washington, DC 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?

$38.90

Typical negotiated rate. In Washington, DC, July 2026.

Insurers have agreed to pay about $38.90 for this service. The price depends on where it is billed: about $38.90 from a physician practice, and about $129 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$38.90$28.84 to $47.86
FacilityA hospital or hospital-owned outpatient department$129$89.13 to $148

How much rates vary

Facilitymedian $129 · 10th to 90th $60 to $151Professionalmedian $39 · 10th to 90th $22 to $59
$10$20$50$100$200$500facility $129professional $39

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
$60.26
Median
$128.82
Typical High
$151.36
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$64.57
Median
$117.49
Typical High
$117.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$38.02
Typical High
$54.95
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$33.11
Median
$64.57
Typical High
$85.11
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$27.54
Typical High
$81.28
Cigna
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$46.77
Typical High
$95.50
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$67.61
Typical High
$93.33
United
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$19.95
Typical High
$36.31
United
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$48.98
Typical High
$100.00
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$72.44
Median
$89.13
Typical High
$112.20

Where Washington, DC 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.

Washington, DC· 51st of 51

$38.90

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.