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Office Visit, Established Patient (Low Complexity)

Oregon 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?

$93.33

Typical negotiated rate. In Oregon, July 2026.

Insurers have agreed to pay about $93.33 for this service. The price depends on where it is billed: about $93.33 from a physician practice, and about $110 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 9 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$93.33$70.79 to $126
FacilityA hospital or hospital-owned outpatient department$110$75.86 to $151

How much rates vary

Facilitymedian $110 · 10th to 90th $55 to $182Professionalmedian $93 · 10th to 90th $54 to $219
$20$50$100$200$500facility $110professional $93

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
$120.23
Typical High
$371.54
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$57.54
Median
$218.78
Typical High
$588.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$91.20
Typical High
$213.80
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$53.70
Median
$93.33
Typical High
$245.47
Cigna
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$117.49
Typical High
$117.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$117.49
Typical High
$204.17
HealthNet
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$186.21
Typical High
$251.19
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$154.88
Typical High
$223.87
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$85.11
Typical High
$147.91
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$128.82
Typical High
$218.78
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$141.25
Typical High
$181.97
Providence
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$85.11
Typical High
$154.88
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$141.25
Typical High
$229.09
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$66.07
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$158.49
Typical High
$234.42
United
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
United
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$112.20
Typical High
$173.78
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$48.98
Median
$91.20
Typical High
$141.25

Where Oregon 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.

Oregon· 2nd of 51

$93.33

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.