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Office Visit, Established Patient (Low Complexity)

Nevada 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 Nevada, 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 $95.50 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 7 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 $115
FacilityA hospital or hospital-owned outpatient department$95.50$85.11 to $145

How much rates vary

Facilitymedian $95 · 10th to 90th $69 to $224Professionalmedian $85 · 10th to 90th $50 to $186
$20$50$100$200$500facility $95professional $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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$138.04
Typical High
$234.42
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$478.63
Median
$478.63
Typical High
$1,445.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$85.11
Typical High
$190.55
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$53.70
Median
$91.20
Typical High
$239.88
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$89.13
Typical High
$131.83
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$75.86
Median
$93.33
Typical High
$131.83
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$83.18
Typical High
$151.36
Cigna
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$128.82
Typical High
$194.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$75.86
Typical High
$131.83
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$75.86
Typical High
$123.03
Hometown Health
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$218.78
Median
$218.78
Typical High
$218.78
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$141.25
Select Health
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$85.11
Typical High
$95.50
Select Health
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$57.54
Typical High
$186.21
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$75.86
Typical High
$213.80
United
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$74.13
Typical High
$131.83
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$48.98
Median
$112.20
Typical High
$177.83

Where Nevada 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.

Nevada· 25th 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.