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Office Visit, Established Patient (Straightforward)

Ohio 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 $46 · 10th–90th $28$1020%20%10th90th$46Professionalmedian $48 · 10th–90th $26$950%5%10th90th$48$1.0$5.0$20.0$100.0$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
$27.54
Median
$45.71
Typical High
$100.00
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$28.18
Median
$48.98
Typical High
$102.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$44.67
Typical High
$91.20
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$34.67
Median
$60.26
Typical High
$112.20
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$52.48
Typical High
$74.13
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$36.31
Median
$54.95
Typical High
$74.13
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$39.81
Typical High
$67.61
Aultcare
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$56.23
Typical High
$85.11
CareSource
Setting
Facility
Modifier
Global
Typical Low
$27.54
Median
$36.31
Typical High
$45.71
CareSource
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$56.23
Typical High
$74.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$109.65
Typical High
$165.96
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
$47.86
Typical High
$89.13
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$144.54
Typical High
$281.84
Medical Mutual of Ohio
Setting
Facility
Modifier
22 · Increased work
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Medical Mutual of Ohio
Setting
Facility
Modifier
62 · Two surgeons
Typical Low
$33.88
Median
$33.88
Typical High
$33.88
Medical Mutual of Ohio
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$5.37
Median
$5.37
Typical High
$5.37
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$51.29
Typical High
$77.62
Molina
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$33.11
Typical High
$63.10
Optum
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$52.48
Typical High
$95.50
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$48.98
Typical High
$75.86
United
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$69.18
Typical High
$173.78
United
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$43.65
Typical High
$95.50
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$54.95
Median
$75.86
Typical High
$89.13