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Office Visit, Established Patient (Straightforward)

Iowa 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?

$54.95

Typical negotiated rate. In Iowa, July 2026.

Insurers have agreed to pay about $54.95 for this service. The price depends on where it is billed: about $54.95 from a physician practice, and about $64.57 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$54.95$41.69 to $81.28
FacilityA hospital or hospital-owned outpatient department$64.57$47.86 to $97.72

How much rates vary

Facilitymedian $65 · 10th to 90th $32 to $132Professionalmedian $55 · 10th to 90th $29 to $123
$20$50$100$200facility $65professional $55

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
$47.86
Median
$83.18
Typical High
$158.49
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$66.07
Median
$66.07
Typical High
$524.81
Aetna
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$54.95
Typical High
$123.03
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$37.15
Median
$66.07
Typical High
$128.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$58.88
Typical High
$125.89
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$67.61
Typical High
$107.15
Medica
Setting
Facility
Modifier
Global
Typical Low
$27.54
Median
$48.98
Typical High
$83.18
Medica
Setting
Facility
Modifier
62 · Two surgeons
Typical Low
$93.33
Median
$100.00
Typical High
$100.00
Medica
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$15.14
Median
$15.85
Typical High
$15.85
Medica
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$72.44
Typical High
$354.81
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$63.10
Median
$95.50
Typical High
$131.83
Midlands
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$81.28
Typical High
$120.23
Midlands
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$83.18
Typical High
$123.03
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$75.86
Typical High
$75.86
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$61.66
Typical High
$123.03
United
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$47.86
Typical High
$69.18
United
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$58.88
Typical High
$112.20
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$85.11
Typical High
$85.11
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$46.77
Typical High
$81.28

Where Iowa 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.

Iowa· 11th of 51

$54.95

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.