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Office Visit, Established Patient (Moderate Complexity)

Colorado 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?

$110

Typical negotiated rate. In Colorado, July 2026.

Insurers have agreed to pay about $110 for this service. The price depends on where it is billed: about $110 from a physician practice, and about $120 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$110$85.11 to $148
FacilityA hospital or hospital-owned outpatient department$120$91.20 to $162

How much rates vary

Facilitymedian $120 · 10th to 90th $68 to $251Professionalmedian $110 · 10th to 90th $66 to $251
$10$20$50$100$200$500facility $120professional $110

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
$117.49
Typical High
$501.19
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$91.20
Median
$269.15
Typical High
$512.86
Aetna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$109.65
Typical High
$251.19
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$58.88
Median
$123.03
Typical High
$302.00
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$107.15
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$134.90
Typical High
$208.93
Anthem BCBS
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
Cigna
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$151.36
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$131.83
Typical High
$218.78
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$120.23
Typical High
$199.53
Denver HMP
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$190.55
Typical High
$354.81
Select Health
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$104.71
Select Health
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$112.20
Typical High
$151.36
United
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$165.96
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$123.03
Typical High
$213.80
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$128.82
Typical High
$194.98

Where Colorado 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.

Colorado· 33rd of 51

$110

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.