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Office Visit, Established Patient (Straightforward)

West Virginia 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?

$47.86

Typical negotiated rate. In West Virginia, July 2026.

Insurers have agreed to pay about $47.86 for this service. The price depends on where it is billed: about $47.86 from a physician practice, and about $46.77 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 5 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$47.86$34.67 to $70.79
FacilityA hospital or hospital-owned outpatient department$46.77$38.90 to $69.18

How much rates vary

Facilitymedian $47 · 10th to 90th $30 to $138Professionalmedian $48 · 10th to 90th $26 to $102
$10$20$50$100facility $47professional $48

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
$30.20
Median
$46.77
Typical High
$138.04
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$38.90
Median
$50.12
Typical High
$257.04
Aetna
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$47.86
Typical High
$102.33
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$37.15
Median
$58.88
Typical High
$109.65
CareSource
Setting
Facility
Modifier
Global
Typical Low
$32.36
Median
$36.31
Typical High
$44.67
CareSource
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$54.95
Typical High
$75.86
Cigna
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$50.12
Typical High
$134.90
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
$30.20
Median
$51.29
Typical High
$288.40
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$6.31
Median
$6.31
Typical High
$6.31
Highmark BCBS
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$58.88
Typical High
$95.50
Highmark BCBS
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$38.90
Median
$58.88
Typical High
$64.57
United
Setting
Facility
Modifier
Global
Typical Low
$38.90
Median
$69.18
Typical High
$85.11
United
Setting
Professional
Modifier
Global
Typical Low
$22.39
Median
$39.81
Typical High
$79.43
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$54.95
Median
$79.43
Typical High
$89.13

Where West Virginia 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.

West Virginia· 30th of 51

$47.86

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.