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Office Visit, Established Patient (Low Complexity)

Florida 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 Florida, 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 $69.18 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 8 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$58.88 to $100
FacilityA hospital or hospital-owned outpatient department$69.18$52.48 to $209

How much rates vary

Facilitymedian $69 · 10th to 90th $42 to $302Professionalmedian $76 · 10th to 90th $47 to $166
$20$50$100$200$500facility $69professional $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
$41.69
Median
$66.07
Typical High
$302.00
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$85.11
Median
$288.40
Typical High
$758.58
Aetna
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$75.86
Typical High
$165.96
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$54.95
Median
$89.13
Typical High
$194.98
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$85.11
Typical High
$123.03
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$67.61
Median
$91.20
Typical High
$134.90
AvMed
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$64.57
Typical High
$70.79
AvMed
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$70.79
Typical High
$100.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$138.04
Typical High
$204.17
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
$51.29
Median
$81.28
Typical High
$144.54
Florida Blue
Setting
Facility
Modifier
Global
Typical Low
$30.20
Median
$213.80
Typical High
$416.87
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$74.13
Typical High
$151.36
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$38.02
Typical High
$85.11
United
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$109.65
Typical High
$169.82
United
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$70.79
Typical High
$141.25
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$97.72
Typical High
$120.23
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$34.67
Typical High
$93.33

Where Florida 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.

Florida· 39th 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.