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Office Visit, Established Patient (Straightforward)

Michigan 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?

$48.98

Typical negotiated rate. In Michigan, July 2026.

Insurers have agreed to pay about $48.98 for this service. The price depends on where it is billed: about $48.98 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 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$48.98$36.31 to $66.07
FacilityA hospital or hospital-owned outpatient department$57.54$38.90 to $72.44

How much rates vary

Facilitymedian $58 · 10th to 90th $32 to $120Professionalmedian $49 · 10th to 90th $28 to $105
$20$50$100$200$500facility $58professional $49

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
$57.54
Typical High
$120.23
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$85.11
Median
$151.36
Typical High
$158.49
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
$58.88
Typical High
$109.65
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$51.29
Typical High
$77.62
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$41.69
Median
$56.23
Typical High
$75.86
BCBS
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$52.48
Typical High
$60.26
BCBS
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$56.23
Typical High
$74.13
CareSource
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$42.66
Typical High
$46.77
CareSource
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$70.79
Typical High
$74.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$44.67
Typical High
$102.33
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$28.18
Median
$43.65
Typical High
$58.88
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$42.66
Typical High
$69.18
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$102.33
Typical High
$204.17
United
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$85.11
Typical High
$144.54
United
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$47.86
Typical High
$104.71
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$47.86
Median
$89.13
Typical High
$112.20

Where Michigan 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.

Michigan· 25th of 51

$48.98

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.