go back

Office Visit, Established Patient (Low Complexity)

South Carolina 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?

$77.62

Typical negotiated rate. In South Carolina, July 2026.

Insurers have agreed to pay about $77.62 for this service. The price depends on where it is billed: about $77.62 from a physician practice, and about $83.18 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$77.62$60.26 to $102
FacilityA hospital or hospital-owned outpatient department$83.18$61.66 to $123

How much rates vary

Facilitymedian $83 · 10th to 90th $51 to $162Professionalmedian $78 · 10th to 90th $47 to $170
$20$50$100$200facility $83professional $78

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
$109.65
Typical High
$181.97
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$134.90
Median
$204.17
Typical High
$257.04
Aetna
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$77.62
Typical High
$169.82
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$54.95
Median
$87.10
Typical High
$194.98
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$85.11
Typical High
$134.90
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$61.66
Median
$91.20
Typical High
$138.04
BCBS
Setting
Facility
Modifier
Global
Typical Low
$16.60
Median
$109.65
Typical High
$269.15
BCBS
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$52.48
Typical High
$79.43
Cigna
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$95.50
Typical High
$245.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$74.13
Typical High
$131.83
Medcost
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$75.86
Typical High
$79.43
Medcost
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$77.62
Typical High
$125.89
Medcost
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$181.97
United
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$128.82
United
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$63.10
Typical High
$109.65
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$89.13
Typical High
$154.88

Where South Carolina 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.

South Carolina· 37th of 51

$77.62

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.