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Office Visit, Established Patient (Straightforward)

Missouri 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 Missouri, 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 $53.70 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$35.48 to $67.61
FacilityA hospital or hospital-owned outpatient department$53.70$38.02 to $97.72

How much rates vary

Facilitymedian $54 · 10th to 90th $28 to $155Professionalmedian $49 · 10th to 90th $27 to $95
$20$50$100$200$500$1Kfacility $54professional $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
$30.20
Median
$64.57
Typical High
$177.83
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$109.65
Median
$181.97
Typical High
$346.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$48.98
Typical High
$95.50
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$34.67
Median
$60.26
Typical High
$114.82
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$53.70
Typical High
$75.86
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$36.31
Median
$54.95
Typical High
$72.44
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$40.74
Typical High
$61.66
BCBS
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$50.12
Typical High
$69.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$144.54
Typical High
$199.53
Cigna
Setting
Facility
Modifier
22 · Increased work
Typical Low
$60.26
Median
$60.26
Typical High
$60.26
Cigna
Setting
Facility
Modifier
62 · Two surgeons
Typical Low
$31.62
Median
$31.62
Typical High
$31.62
Cigna
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$5.01
Median
$5.01
Typical High
$5.01
Cigna
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$45.71
Typical High
$83.18
Medica
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$45.71
Typical High
$89.13
Medica
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$57.54
Median
$177.83
Typical High
$257.04
Medica
Setting
Facility
Modifier
62 · Two surgeons
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Medica
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$15.85
Median
$15.85
Typical High
$15.85
Medica
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$57.54
Typical High
$354.81
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$42.66
Median
$64.57
Typical High
$128.82
Qualchoice
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$61.66
Typical High
$74.13
Qualchoice
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$53.70
Median
$63.10
Typical High
$72.44
United
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$69.18
Typical High
$138.04
United
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$44.67
Typical High
$89.13
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$28.84
Median
$79.43
Typical High
$89.13

Where Missouri 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.

Missouri· 26th 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.