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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 October 2026.

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

$36.31

Typical physician fee. In Washington, DC, October 2026.

Insurers have agreed to pay about $36.31 for this service. Most negotiated rates run $30.20 to $50.12.

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 $81 · 10th to 90th $29 to $141Professionalmedian $36 · 10th to 90th $25 to $58
$20$50$100facility $81professional $36

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
$28.84
Median
$81.28
Typical High
$138.04
Aetna
Setting
Professional
Modifier
None
Typical Low
$25.12
Median
$41.69
Typical High
$54.95
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$16.22
Median
$16.60
Typical High
$27.54
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$4.90
Median
$5.01
Typical High
$8.32
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$3.24
Median
$3.39
Typical High
$5.62
CareFirst
Setting
Professional
Modifier
None
Typical Low
$28.84
Median
$30.90
Typical High
$31.62
Cigna
Setting
Facility
Modifier
None
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Cigna
Setting
Professional
Modifier
None
Typical Low
$28.84
Median
$44.67
Typical High
$66.07
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$57.54
Median
$67.61
Typical High
$93.33
United
Setting
Professional
Modifier
None
Typical Low
$19.95
Median
$38.90
Typical High
$72.44

Where Washington, DC 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.

Washington, DC· 48th of 51

$36.31

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.