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Office Visit, Established Patient (Straightforward)

Georgia 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?

$47.86

Typical negotiated rate. In Georgia, July 2026.

Insurers have agreed to pay about $47.86 for this service. The price depends on where it is billed: about $47.86 from a physician practice, and about $61.66 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 8 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$47.86$37.15 to $64.57
FacilityA hospital or hospital-owned outpatient department$61.66$34.67 to $170

How much rates vary

Facilitymedian $62 · 10th to 90th $29 to $372Professionalmedian $48 · 10th to 90th $28 to $100
$20$50$100$200$500$1Kfacility $62professional $48

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
$28.84
Median
$56.23
Typical High
$371.54
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$95.50
Median
$302.00
Typical High
$741.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$28.18
Median
$47.86
Typical High
$100.00
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$34.67
Median
$60.26
Typical High
$109.65
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$56.23
Typical High
$87.10
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$44.67
Median
$57.54
Typical High
$83.18
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$43.65
Typical High
$89.13
Anthem BCBS
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$34.67
Median
$34.67
Typical High
$34.67
CareSource
Setting
Facility
Modifier
Global
Typical Low
$32.36
Median
$42.66
Typical High
$47.86
CareSource
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$66.07
Typical High
$81.28
Cigna
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$144.54
Typical High
$251.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$46.77
Typical High
$89.13
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$60.26
Typical High
$102.33
Kaiser Permanente
Setting
Professional
Modifier
22 · Increased work
Typical Low
$91.20
Median
$114.82
Typical High
$186.21
Kaiser Permanente
Setting
Professional
Modifier
62 · Two surgeons
Typical Low
$28.18
Median
$36.31
Typical High
$57.54
Kaiser Permanente
Setting
Professional
Modifier
80 · Assistant surgeon
Typical Low
$2.40
Median
$3.09
Typical High
$4.90
Kaiser Permanente
Setting
Professional
Modifier
AS · PA/NP assist
Typical Low
$1.20
Median
$1.51
Typical High
$2.45
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$123.03
Typical High
$549.54
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$61.66
Typical High
$109.65
United
Setting
Facility
Modifier
Global
Typical Low
$25.12
Median
$48.98
Typical High
$141.25
United
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$43.65
Typical High
$89.13
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$28.84
Median
$70.79
Typical High
$89.13

Where Georgia 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.

Georgia· 29th of 51

$47.86

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.