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Office Visit, Established Patient (Straightforward)

Utah 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?

$54.95

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $54.95 for this service. The price depends on where it is billed: about $54.95 from a physician practice, and about $50.12 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$54.95$38.90 to $70.79
FacilityA hospital or hospital-owned outpatient department$50.12$46.77 to $100

How much rates vary

Facilitymedian $50 · 10th to 90th $36 to $100Professionalmedian $55 · 10th to 90th $29 to $117
$10$20$50$100$200facility $50professional $55

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
$36.31
Median
$50.12
Typical High
$100.00
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$125.89
Median
$302.00
Typical High
$302.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$54.95
Typical High
$120.23
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$33.11
Median
$57.54
Typical High
$114.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$120.23
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$46.77
Typical High
$89.13
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$69.18
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$52.48
Typical High
$81.28
Select Health
Setting
Facility
Modifier
Global
Typical Low
$40.74
Median
$40.74
Typical High
$61.66
Select Health
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$53.70
Typical High
$102.33
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$58.88
Typical High
$104.71
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$85.11
United
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$44.67
Typical High
$79.43
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$51.29
Median
$67.61
Typical High
$89.13

Where Utah 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.

Utah· 9th of 51

$54.95

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.