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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.

How much does Office Visit, Established Patient (Straightforward) cost?

$44.67

Typical negotiated rate. In Maine, July 2026.

Insurers have agreed to pay about $44.67 for this service. The price depends on where it is billed: about $44.67 from a physician practice, and about $57.54 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 7 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$44.67$35.48 to $58.88
FacilityA hospital or hospital-owned outpatient department$57.54$39.81 to $115

How much rates vary

Facilitymedian $58 · 10th to 90th $22 to $204Professionalmedian $45 · 10th to 90th $26 to $89
$1.0$10.0$100.0$1.0K$10.0Kfacility $58professional $45

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
$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

Where Maine 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.

Maine $44.67 · 36th 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.