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Office Visit, Established Patient (Low Complexity)

Delaware 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?

$67.61

Typical physician fee. In Delaware, July 2026.

Insurers have agreed to pay about $67.61 for this service. Most negotiated rates run $53.70 to $91.20.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $71 · 10th to 90th $52 to $309Professionalmedian $68 · 10th to 90th $44 to $141
$20$50$100$200$500facility $71professional $68

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
$52.48
Median
$70.79
Typical High
$309.03
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$46.77
Median
$251.19
Typical High
$354.81
Aetna
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$67.61
Typical High
$138.04
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$63.10
Median
$97.72
Typical High
$263.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$131.83
Typical High
$199.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$72.44
Typical High
$138.04
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$151.36
Typical High
$223.87
Highmark BCBS
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$83.18
Median
$114.82
Typical High
$186.21
United
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$70.79
Typical High
$131.83
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$89.13
Median
$89.13
Typical High
$102.33

Where Delaware 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.

Delaware· 50th of 51

$67.61

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.