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Office Visit, Established Patient (Low Complexity)

Arkansas rates for HCPCS 99213

A standard follow-up appointment with a doctor or other provider the patient has seen before, used for common, everyday medical concerns that require some evaluation and decision-making but aren't highly complex. It's one of the most frequently used visit levels for routine follow-ups, such as checking on a stable chronic condition or addressing a new but uncomplicated symptom. It sits between the most basic and more complex visit levels.

Rates data updated July 2026.

How much does Office Visit, Established Patient (Low Complexity) cost?

$75.86

Typical negotiated rate. In Arkansas, July 2026.

Insurers have agreed to pay about $75.86 for this service. The price depends on where it is billed: about $75.86 from a physician practice, and about $60.26 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$75.86$60.26 to $93.33
FacilityA hospital or hospital-owned outpatient department$60.26$54.95 to $79.43

How much rates vary

Facilitymedian $60 · 10th to 90th $49 to $105Professionalmedian $76 · 10th to 90th $50 to $126
$50$100$200facility $60professional $76

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
$48.98
Median
$60.26
Typical High
$93.33
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$67.61
Median
$131.83
Typical High
$154.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$75.86
Typical High
$125.89
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$53.70
Median
$81.28
Typical High
$125.89
Aetna
Setting
Professional
Modifier
50 · Both sides
Typical Low
$239.88
Median
$239.88
Typical High
$239.88
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$81.28
Typical High
$109.65
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$58.88
Median
$89.13
Typical High
$109.65
BCBS
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$74.13
Typical High
$102.33
BCBS
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$69.18
Typical High
$95.50
CareSource
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$79.43
Typical High
$89.13
CareSource
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$114.82
Typical High
$138.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$109.65
Typical High
$134.90
Cigna
Setting
Facility
Modifier
22 · Increased work
Typical Low
$97.72
Median
$97.72
Typical High
$97.72
Cigna
Setting
Facility
Modifier
62 · Two surgeons
Typical Low
$51.29
Median
$51.29
Typical High
$51.29
Cigna
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$8.13
Median
$8.13
Typical High
$8.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$74.13
Typical High
$123.03
Qualchoice
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$102.33
Typical High
$138.04
Qualchoice
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$72.44
Median
$107.15
Typical High
$138.04
United
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$109.65
Typical High
$141.25
United
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$70.79
Typical High
$114.82
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$83.18
Median
$89.13
Typical High
$112.20

Where Arkansas 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.

Arkansas· 44th of 51

$75.86

MN $97.72DC $61.66

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.