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Office Visit, Established Patient (Straightforward)

Idaho 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?

$53.70

Typical negotiated rate. In Idaho, July 2026.

Insurers have agreed to pay about $53.70 for this service. The price depends on where it is billed: about $53.70 from a physician practice, and about $56.23 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$53.70$40.74 to $75.86
FacilityA hospital or hospital-owned outpatient department$56.23$41.69 to $83.18

How much rates vary

Facilitymedian $56 · 10th to 90th $32 to $158Professionalmedian $54 · 10th to 90th $30 to $151
$20$50$100$200facility $56professional $54

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
$41.69
Median
$81.28
Typical High
$208.93
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$42.66
Median
$51.29
Typical High
$141.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$53.70
Typical High
$151.36
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$35.48
Median
$61.66
Typical High
$154.88
BCBS
Setting
Facility
Modifier
Global
Typical Low
$42.66
Median
$42.66
Typical High
$42.66
BCBS
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$75.86
Typical High
$114.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$74.13
Typical High
$74.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$53.70
Typical High
$95.50
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$28.18
Median
$50.12
Typical High
$87.10
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$66.07
Typical High
$117.49
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$109.65
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$66.07
Typical High
$100.00
Select Health
Setting
Facility
Modifier
Global
Typical Low
$32.36
Median
$37.15
Typical High
$57.54
Select Health
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$56.23
Typical High
$91.20
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$69.18
United
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$52.48
Typical High
$89.13
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$28.84
Median
$79.43
Typical High
$89.13

Where Idaho 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.

Idaho· 13th of 51

$53.70

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.