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Office Visit, Established Patient (Straightforward)

Wisconsin 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 $58 · 10th–90th $28$2950%10%10th90th$58Professionalmedian $66 · 10th–90th $30$1580%10%10th90th$66$0.2$1.0$5.0$20.0$100.0$500.0$2.0K

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
$36.31
Median
$147.91
Typical High
$295.12
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$186.21
Median
$489.78
Typical High
$1,148.15
Aetna
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$52.48
Typical High
$165.96
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$33.88
Median
$72.44
Typical High
$162.18
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$64.57
Typical High
$114.82
CareSource
Setting
Facility
Modifier
Global
Typical Low
$32.36
Median
$39.81
Typical High
$45.71
CareSource
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$66.07
Typical High
$79.43
Cigna
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$177.83
Typical High
$257.04
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
$35.48
Median
$79.43
Typical High
$162.18
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$25.12
Median
$42.66
Typical High
$85.11
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$89.13
Typical High
$144.54
Medica
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$44.67
Typical High
$97.72
Medica
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$109.65
Median
$109.65
Typical High
$109.65
Medica
Setting
Facility
Modifier
62 · Two surgeons
Typical Low
$93.33
Median
$100.00
Typical High
$100.00
Medica
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$15.14
Median
$15.85
Typical High
$15.85
Medica
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$97.72
Typical High
$354.81
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$85.11
Median
$114.82
Typical High
$147.91
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$74.13
Network Health
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$70.79
Typical High
$112.20
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$25.12
Median
$42.66
Typical High
$85.11
Quartz
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$87.10
Typical High
$141.25
Quartz
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$223.87
Quartz
Setting
Facility
Modifier
22 · Increased work
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Quartz
Setting
Facility
Modifier
62 · Two surgeons
Typical Low
$40.74
Median
$40.74
Typical High
$141.25
Quartz
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$6.46
Median
$6.46
Typical High
$22.39
Quartz
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$75.86
Typical High
$354.81
Security Health
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$42.66
Typical High
$66.07
Security Health
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$72.44
Typical High
$117.49
United
Setting
Facility
Modifier
Global
Typical Low
$33.11
Median
$45.71
Typical High
$61.66
United
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$95.50
Typical High
$138.04
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$85.11
Typical High
$91.20