go back

Office Visit, Established Patient (Straightforward)

Delaware 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 physician fee. In Delaware, July 2026.

Insurers have agreed to pay about $38.90 for this service. Most negotiated rates run $30.90 to $47.86.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $45 · 10th to 90th $28 to $214Professionalmedian $39 · 10th to 90th $23 to $68
$20$50$100$200$500facility $45professional $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
$28.18
Median
$44.67
Typical High
$213.80
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$213.80
Typical High
$316.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$38.90
Typical High
$67.61
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$38.90
Median
$69.18
Typical High
$114.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$131.83
Typical High
$199.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$44.67
Typical High
$83.18
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$60.26
Typical High
$173.78
Highmark BCBS
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$57.54
Median
$67.61
Typical High
$144.54
United
Setting
Professional
Modifier
Global
Typical Low
$22.91
Median
$43.65
Typical High
$79.43
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$89.13
Median
$89.13
Typical High
$89.13

Where Delaware 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.

Delaware· 50th 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.