go back

Office Visit, Established Patient (Low Complexity)

Colorado 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?

$79.43

Typical negotiated rate. In Colorado, July 2026.

Insurers have agreed to pay about $79.43 for this service. The price depends on where it is billed: about $79.43 from a physician practice, and about $89.13 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$79.43$60.26 to $100
FacilityA hospital or hospital-owned outpatient department$89.13$66.07 to $135

How much rates vary

Facilitymedian $89 · 10th to 90th $51 to $275Professionalmedian $79 · 10th to 90th $49 to $170
$20$50$100$200$500facility $89professional $79

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
$51.29
Median
$114.82
Typical High
$501.19
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$79.43
Typical High
$169.82
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$52.48
Median
$89.13
Typical High
$208.93
Aetna
Setting
Professional
Modifier
50 · Both sides
Typical Low
$239.88
Median
$239.88
Typical High
$239.88
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$93.33
Typical High
$147.91
Anthem BCBS
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$48.98
Median
$48.98
Typical High
$48.98
Cigna
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$147.91
Typical High
$190.55
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
$54.95
Median
$89.13
Typical High
$147.91
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$83.18
Typical High
$134.90
Denver HMP
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$134.90
Typical High
$234.42
Select Health
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Select Health
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$75.86
Typical High
$102.33
United
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$154.88
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$85.11
Typical High
$147.91
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$89.13
Typical High
$123.03

Where Colorado 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.

Colorado· 34th of 51

$79.43

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.