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Office Visit, Established Patient (Moderate Complexity)

Alabama rates for HCPCS 99214

A follow-up appointment with a doctor or other provider the patient has seen before, involving a moderate level of medical decision-making, such as managing several ongoing conditions or a condition that has changed and needs a closer look. It typically takes more time and involves more discussion and evaluation than a routine, simple check-in. The exact length varies, but it reflects a meaningful step up in complexity from the most basic follow-up visit.

Rates data updated July 2026.

How much does Office Visit, Established Patient (Moderate Complexity) cost?

$100

Typical negotiated rate. In Alabama, July 2026.

Insurers have agreed to pay about $100 for this service. The price depends on where it is billed: about $100 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 5 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$100$79.43 to $132
FacilityA hospital or hospital-owned outpatient department$79.43$67.61 to $105

How much rates vary

Facilitymedian $79 · 10th to 90th $59 to $126Professionalmedian $100 · 10th to 90th $63 to $200
$20$50$100$200facility $79professional $100

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
$58.88
Median
$79.43
Typical High
$112.20
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Aetna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$100.00
Typical High
$199.53
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$56.23
Median
$107.15
Typical High
$213.80
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$114.82
Typical High
$169.82
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$87.10
Median
$125.89
Typical High
$169.82
BCBS
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$131.83
Typical High
$251.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$134.90
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$107.15
Typical High
$213.80
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$120.23
Typical High
$158.49
United
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$91.20
Typical High
$162.18
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$89.13
Typical High
$181.97

Where Alabama sits

The same service costs 1.7 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.

Alabama· 47th of 51

$100

MN $148DC $89.13

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.