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Office Visit, Established Patient (Straightforward)

Tennessee 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?

$44.67

Typical negotiated rate. In Tennessee, July 2026.

Insurers have agreed to pay about $44.67 for this service. The price depends on where it is billed: about $44.67 from a physician practice, and about $77.62 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 7 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$44.67$34.67 to $57.54
FacilityA hospital or hospital-owned outpatient department$77.62$43.65 to $95.50

How much rates vary

Facilitymedian $78 · 10th to 90th $33 to $224Professionalmedian $45 · 10th to 90th $28 to $87
$10$20$50$100$200facility $78professional $45

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
$33.11
Median
$81.28
Typical High
$102.33
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$87.10
Median
$95.50
Typical High
$95.50
Aetna
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$44.67
Typical High
$87.10
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$39.81
Median
$64.57
Typical High
$120.23
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$54.95
Typical High
$77.62
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$39.81
Median
$54.95
Typical High
$77.62
BCBS
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$47.86
Typical High
$83.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$120.23
Typical High
$208.93
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
$28.18
Median
$44.67
Typical High
$77.62
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$223.87
Typical High
$223.87
Lucent Health
Setting
Facility
Modifier
62 · Two surgeons
Typical Low
$141.25
Median
$141.25
Typical High
$141.25
Lucent Health
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$22.39
Median
$22.39
Typical High
$22.39
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$354.81
Typical High
$354.81
Optum
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$53.70
Typical High
$91.20
United
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$46.77
Typical High
$67.61
United
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$41.69
Typical High
$79.43
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$89.13
Typical High
$100.00

Where Tennessee 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.

Tennessee· 39th of 51

$44.67

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.