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Office Visit, Established Patient (Straightforward)

Texas 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 $47 · 10th–90th $26$1410%10%10th90th$47Professionalmedian $45 · 10th–90th $26$850%5%10%10th90th$45$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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
$28.84
Median
$53.70
Typical High
$416.87
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$64.57
Median
$102.33
Typical High
$190.55
Aetna
Setting
Professional
Modifier
Global
Typical Low
$28.18
Median
$44.67
Typical High
$85.11
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$33.11
Median
$58.88
Typical High
$109.65
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$52.48
Typical High
$70.79
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$39.81
Median
$56.23
Typical High
$69.18
BCBS
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$27.54
Typical High
$46.77
BCBS
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$33.11
Typical High
$50.12
Baylor Scott & White
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$60.26
Typical High
$109.65
Baylor Scott & White
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$58.88
Typical High
$100.00
Christus
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$41.69
Typical High
$57.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$165.96
Typical High
$234.42
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
$46.77
Typical High
$83.18
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$44.67
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
$40.74
Median
$66.07
Typical High
$354.81
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$28.18
Median
$46.77
Typical High
$83.18
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$69.18
Typical High
$109.65
Molina
Setting
Professional
Modifier
Global
Typical Low
$13.49
Median
$26.30
Typical High
$33.11
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$79.43
Typical High
$83.18
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$70.79
Typical High
$218.78
Providence
Setting
Facility
Modifier
Global
Typical Low
$28.18
Median
$47.86
Typical High
$87.10
Providence
Setting
Facility
Modifier
22 · Increased work
Typical Low
$60.26
Median
$60.26
Typical High
$60.26
Providence
Setting
Facility
Modifier
62 · Two surgeons
Typical Low
$31.62
Median
$31.62
Typical High
$31.62
Providence
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$5.01
Median
$5.01
Typical High
$5.01
Providence
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$47.86
Typical High
$89.13
United
Setting
Facility
Modifier
Global
Typical Low
$30.20
Median
$69.18
Typical High
$141.25
United
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$39.81
Typical High
$72.44
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$56.23
Median
$89.13
Typical High
$89.13
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$57.54
Typical High
$79.43