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Office Visit, Established Patient (Straightforward)

Maine 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 $68 · 10th–90th $22$2040%10%10th90th$68Professionalmedian $45 · 10th–90th $26$890%20%10th90th$45$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$22.39
Median
$50.12
Typical High
$204.17
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$67.61
Median
$91.20
Typical High
$288.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$41.69
Typical High
$57.54
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$16.98
Median
$16.98
Typical High
$16.98
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$51.29
Typical High
$89.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$50.12
Typical High
$102.33
Community Health Options
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$87.10
Typical High
$112.20
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$72.44
Typical High
$141.25
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$24.55
Median
$70.79
Typical High
$199.53
Martin's Point
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$67.61
Median
$91.20
Typical High
$288.40
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$39.81
Typical High
$74.13
Martin's Point
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$16.98
Median
$16.98
Typical High
$16.98
United
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$61.66
Typical High
$112.20
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$60.26
Median
$89.13
Typical High
$112.20