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Office Visit, Established Patient (Low Complexity)

Rhode Island 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?

$83.18

Typical negotiated rate. In Rhode Island, July 2026.

Insurers have agreed to pay about $83.18 for this service. The price depends on where it is billed: about $83.18 from a physician practice, and about $79.43 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$83.18$64.57 to $100
FacilityA hospital or hospital-owned outpatient department$79.43$70.79 to $105

How much rates vary

Facilitymedian $79 · 10th to 90th $51 to $245Professionalmedian $83 · 10th to 90th $50 to $162
$10$20$50$100$200$500facility $79professional $83

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
$72.44
Typical High
$245.47
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$107.15
Median
$239.88
Typical High
$354.81
Aetna
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$83.18
Typical High
$162.18
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$52.48
Median
$89.13
Typical High
$199.53
BCBS
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$100.00
Typical High
$158.49
BCBS
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$85.11
Typical High
$125.89
Cigna
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$147.91
Typical High
$173.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$87.10
Typical High
$162.18
United
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$79.43
Typical High
$141.25
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$89.13
Median
$91.20
Typical High
$144.54

Where Rhode Island 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.

Rhode Island· 26th of 51

$83.18

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.