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Office Visit, Established Patient (Low Complexity)

Hawaii 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?

$91.20

Typical negotiated rate. In Hawaii, July 2026.

Insurers have agreed to pay about $91.20 for this service. The price depends on where it is billed: about $91.20 from a physician practice, and about $224 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 6 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$91.20$67.61 to $117
FacilityA hospital or hospital-owned outpatient department$224$204 to $257

How much rates vary

Facilitymedian $224 · 10th to 90th $158 to $479Professionalmedian $91 · 10th to 90th $50 to $224
$20$50$100$200$500facility $224professional $91

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
$158.49
Median
$229.09
Typical High
$478.63
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$128.82
Median
$239.88
Typical High
$602.56
Aetna
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$91.20
Typical High
$223.87
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$56.23
Median
$93.33
Typical High
$257.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$85.11
Typical High
$194.98
HMSA
Setting
Professional
Modifier
Global
Typical Low
$18.20
Median
$25.12
Typical High
$30.20
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$100.00
Typical High
$141.25
United
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$141.25
United
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$77.62
Typical High
$117.49
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$85.11
Median
$102.33
Typical High
$112.20
University Health Alliance
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$109.65
Typical High
$186.21

Where Hawaii 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.

Hawaii· 8th of 51

$91.20

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.