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Office Visit, Established Patient (Straightforward)

New Jersey 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 $51 · 10th–90th $19$2880%5%10%10th90th$51Professionalmedian $47 · 10th–90th $26$930%5%10%10th90th$47$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
$19.50
Median
$43.65
Typical High
$281.84
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$147.91
Median
$147.91
Typical High
$295.12
Aetna
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$44.67
Typical High
$91.20
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$34.67
Median
$58.88
Typical High
$114.82
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$53.70
Typical High
$77.62
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$40.74
Median
$56.23
Typical High
$74.13
AmeriHealth
Setting
Facility
Modifier
Global
Typical Low
$36.31
Median
$36.31
Typical High
$436.52
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$45.71
Typical High
$91.20
Cigna
Setting
Facility
Modifier
Global
Typical Low
$38.90
Median
$169.82
Typical High
$257.04
Cigna
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$48.98
Typical High
$89.13
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$38.90
Typical High
$91.20
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$54.95
Typical High
$87.10
United
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$141.25
Typical High
$223.87
United
Setting
Professional
Modifier
Global
Typical Low
$22.91
Median
$45.71
Typical High
$91.20
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$64.57
Median
$85.11
Typical High
$89.13