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Office Visit, Established Patient (Low Complexity)

North Dakota 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?

$87.10

Typical negotiated rate. In North Dakota, July 2026.

Insurers have agreed to pay about $87.10 for this service. The price depends on where it is billed: about $87.10 from a physician practice, and about $87.10 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 4 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$87.10$66.07 to $145
FacilityA hospital or hospital-owned outpatient department$87.10$60.26 to $214

How much rates vary

Facilitymedian $87 · 10th to 90th $51 to $468Professionalmedian $87 · 10th to 90th $54 to $240
$20$50$100$200$500facility $87professional $87

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
$87.10
Typical High
$467.74
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$190.55
Median
$190.55
Typical High
$537.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$87.10
Typical High
$239.88
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$52.48
Median
$93.33
Typical High
$245.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$134.90
Typical High
$223.87
Medica
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$83.18
Typical High
$158.49
Medica
Setting
Facility
Modifier
62 · Two surgeons
Typical Low
$186.21
Median
$186.21
Typical High
$186.21
Medica
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$29.51
Median
$29.51
Typical High
$29.51
Medica
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$181.97
Typical High
$245.47
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$114.82
Median
$177.83
Typical High
$229.09
United
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
United
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$97.72
Typical High
$173.78
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$85.11
Median
$112.20
Typical High
$204.17

Where North Dakota 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.

North Dakota· 13th of 51

$87.10

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.