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Office Visit, Established Patient (Straightforward)

North Carolina 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 $55 · 10th–90th $31$1380%5%10%10th90th$55Professionalmedian $52 · 10th–90th $29$1070%10%10th90th$52$5.0$10.0$20.0$50.0$100.0$200.0$500.0

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
$35.48
Median
$61.66
Typical High
$162.18
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$34.67
Median
$87.10
Typical High
$204.17
Aetna
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$48.98
Typical High
$107.15
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$33.88
Median
$58.88
Typical High
$117.49
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$54.95
Typical High
$83.18
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$35.48
Median
$56.23
Typical High
$83.18
BCBS
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$52.48
Typical High
$100.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$120.23
Typical High
$151.36
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
$29.51
Median
$48.98
Typical High
$87.10
Medcost
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$45.71
Typical High
$104.71
Medcost
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$47.86
Typical High
$77.62
Medcost
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$114.82
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$61.66
Typical High
$123.03
United
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$75.86
Typical High
$147.91
United
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$41.69
Typical High
$83.18
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$52.48
Median
$79.43
Typical High
$89.13
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$223.87
Typical High
$223.87
Wellcare
Setting
Facility
Modifier
62 · Two surgeons
Typical Low
$141.25
Median
$141.25
Typical High
$141.25
Wellcare
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$22.39
Median
$22.39
Typical High
$22.39
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$354.81
Typical High
$354.81