go back

Office Visit, Established Patient (Low Complexity)

Washington, DC 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?

$61.66

Typical negotiated rate. In Washington, DC, July 2026.

Insurers have agreed to pay about $61.66 for this service. The price depends on where it is billed: about $61.66 from a physician practice, and about $132 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$61.66$50.12 to $77.62
FacilityA hospital or hospital-owned outpatient department$132$126 to $166

How much rates vary

Facilitymedian $132 · 10th to 90th $95 to $195Professionalmedian $62 · 10th to 90th $39 to $100
$20$50$100$200facility $132professional $62

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
$95.50
Median
$131.83
Typical High
$177.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$61.66
Typical High
$97.72
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$20.42
Median
$85.11
Typical High
$162.18
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$51.29
Typical High
$114.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$75.86
Typical High
$151.36
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$107.15
Typical High
$147.91
United
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$58.88
United
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$83.18
Typical High
$154.88
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$89.13
Typical High
$120.23

Where Washington, DC 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.

Washington, DC· 51st of 51

$61.66

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.