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Office Visit, Established Patient (Straightforward)

Maryland 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?

$46.77

Typical negotiated rate. In Maryland, July 2026.

Insurers have agreed to pay about $46.77 for this service. The price depends on where it is billed: about $46.77 from a physician practice, and about $93.33 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 6 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$46.77$34.67 to $64.57
FacilityA hospital or hospital-owned outpatient department$93.33$52.48 to $178

How much rates vary

Facilitymedian $93 · 10th to 90th $32 to $195Professionalmedian $47 · 10th to 90th $25 to $100
$10.0$20.0$50.0$100.0$200.0facility $93professional $47

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
$32.36
Median
$93.33
Typical High
$194.98
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$93.33
Median
$97.72
Typical High
$100.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$47.86
Typical High
$102.33
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$38.02
Median
$63.10
Typical High
$120.23
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$26.30
Typical High
$43.65
Cigna
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$144.54
Typical High
$186.21
Cigna
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$46.77
Typical High
$81.28
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$63.10
Typical High
$91.20
United
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$38.02
Typical High
$131.83
United
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$42.66
Typical High
$85.11
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$52.48
Median
$79.43
Typical High
$100.00
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$58.88
Typical High
$89.13

Where Maryland sits

The same service costs 1.6 times more in Minnesota than in Washington, DC. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Maryland $46.77 · 32nd of 51
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.