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Office Visit, Established Patient (Straightforward)

Rhode Island 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 October 2026.

How much does Office Visit, Established Patient (Straightforward) cost?

$43.65

Typical negotiated rate. In Rhode Island, October 2026.

Insurers have agreed to pay about $43.65 for this service. The price depends on where it is billed: about $43.65 from a physician practice, and about $95.50 from a hospital or other facility.

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 4 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$43.65$33.88 to $53.70
FacilityA hospital or hospital-owned outpatient department$95.50$61.66 to $138

How much rates vary

Facilitymedian $95 · 10th to 90th $38 to $174Professionalmedian $44 · 10th to 90th $26 to $62
$50$100facility $95professional $44

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$26.30
Median
$26.30
Typical High
$43.65
Aetna
Setting
Professional
Modifier
None
Typical Low
$26.30
Median
$43.65
Typical High
$57.54
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$12.88
Median
$19.50
Typical High
$21.88
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$3.89
Median
$5.89
Typical High
$6.46
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$2.57
Median
$3.89
Typical High
$4.37
BCBS Rhode Island
Setting
Facility
Modifier
None
Typical Low
$38.02
Median
$95.50
Typical High
$138.04
BCBS Rhode Island
Setting
Professional
Modifier
None
Typical Low
$32.36
Median
$45.71
Typical High
$67.61
Cigna
Setting
Facility
Modifier
None
Typical Low
$151.36
Median
$173.78
Typical High
$173.78
Cigna
Setting
Professional
Modifier
None
Typical Low
$33.88
Median
$47.86
Typical High
$53.70
United
Setting
Professional
Modifier
None
Typical Low
$24.55
Median
$40.74
Typical High
$60.26

Where Rhode Island sits

The same service costs 2.4 times more in Alaska than in New Jersey. 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.

Rhode Island· 24th of 51

$43.65

AK $77.62NJ $32.36

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.