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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 July 2026.

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

$46.77

Typical negotiated rate. In Rhode Island, July 2026.

Insurers have agreed to pay about $46.77 for this service. The price depends on where it is billed: about $46.77 from a physician practice, and about $43.65 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 4 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$46.77$36.31 to $60.26
FacilityA hospital or hospital-owned outpatient department$43.65$26.30 to $97.72

How much rates vary

Facilitymedian $44 · 10th to 90th $26 to $245Professionalmedian $47 · 10th to 90th $26 to $87
$10$20$50$100$200facility $44professional $47

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
$26.30
Median
$43.65
Typical High
$245.47
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$67.61
Median
$128.82
Typical High
$251.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$46.77
Typical High
$87.10
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$38.02
Median
$60.26
Typical High
$120.23
BCBS
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$61.66
Typical High
$107.15
BCBS
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$50.12
Typical High
$77.62
Cigna
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$151.36
Typical High
$173.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$51.29
Typical High
$100.00
United
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$48.98
Typical High
$89.13
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$89.13
Median
$89.13
Typical High
$89.13

Where Rhode Island 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.

Rhode Island· 33rd of 51

$46.77

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.