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Office Visit, Established Patient (Straightforward)

Illinois 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.

Facilitymedian $87 · 10th–90th $30$1950%5%10th90th$87Professionalmedian $52 · 10th–90th $30$1070%5%10th90th$52$1.0$5.0$20.0$100.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$29.51
Median
$81.28
Typical High
$194.98
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$69.18
Median
$120.23
Typical High
$194.98
Aetna
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$48.98
Typical High
$107.15
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$34.67
Median
$60.26
Typical High
$117.49
Aetna
Setting
Professional
Modifier
50 · Both sides
Typical Low
$47.86
Median
$47.86
Typical High
$47.86
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$54.95
Typical High
$77.62
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$36.31
Median
$56.23
Typical High
$77.62
BCBS
Setting
Facility
Modifier
Global
Typical Low
$27.54
Median
$123.03
Typical High
$138.04
BCBS
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$50.12
Typical High
$64.57
Cigna
Setting
Facility
Modifier
Global
Typical Low
$42.66
Median
$125.89
Typical High
$158.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$51.29
Typical High
$89.13
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$69.18
Typical High
$114.82
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$63.10
Typical High
$74.13
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$91.20
United
Setting
Facility
Modifier
Global
Typical Low
$38.90
Median
$75.86
Typical High
$134.90
United
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$64.57
Typical High
$107.15
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$60.26
Median
$79.43
Typical High
$100.00