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Office Visit, Established Patient (Low Complexity)

Nebraska 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?

$85.11

Typical negotiated rate. In Nebraska, July 2026.

Insurers have agreed to pay about $85.11 for this service. The price depends on where it is billed: about $85.11 from a physician practice, and about $123 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$85.11$64.57 to $129
FacilityA hospital or hospital-owned outpatient department$123$83.18 to $186

How much rates vary

Facilitymedian $123 · 10th to 90th $56 to $389Professionalmedian $85 · 10th to 90th $52 to $166
$50$100$200$500facility $123professional $85

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
$56.23
Median
$134.90
Typical High
$389.05
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$77.62
Median
$602.56
Typical High
$602.56
Aetna
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$83.18
Typical High
$162.18
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$54.95
Median
$85.11
Typical High
$165.96
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$95.50
Typical High
$173.78
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$75.86
Median
$107.15
Typical High
$173.78
BCBS
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$162.18
Typical High
$229.09
BCBS
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$112.20
Typical High
$169.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$117.49
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$107.15
Typical High
$213.80
Medica
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$83.18
Typical High
$151.36
Medica
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$194.98
Median
$199.53
Typical High
$229.09
Medica
Setting
Facility
Modifier
62 · Two surgeons
Typical Low
$151.36
Median
$186.21
Typical High
$186.21
Medica
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$23.99
Median
$29.51
Typical High
$29.51
Medica
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$162.18
Typical High
$213.80
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$114.82
Median
$154.88
Typical High
$194.98
Midlands
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$134.90
Typical High
$177.83
Midlands
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$128.82
Typical High
$204.17
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$275.42
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$91.20
Typical High
$154.88
United
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$112.20
Typical High
$177.83
United
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$95.50
Typical High
$173.78
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$41.69
Median
$97.72
Typical High
$120.23

Where Nebraska 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.

Nebraska· 24th of 51

$85.11

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.