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Office Visit, Established Patient (Moderate Complexity)

Connecticut 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?

$107

Typical negotiated rate. In Connecticut, July 2026.

Insurers have agreed to pay about $107 for this service. The price depends on where it is billed: about $107 from a physician practice, and about $195 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 6 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$107$81.28 to $155
FacilityA hospital or hospital-owned outpatient department$195$93.33 to $282

How much rates vary

Facilitymedian $195 · 10th to 90th $71 to $339Professionalmedian $107 · 10th to 90th $62 to $251
$20$50$100$200$500facility $195professional $107

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
$70.79
Median
$199.53
Typical High
$338.84
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$69.18
Median
$281.84
Typical High
$426.58
Aetna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$107.15
Typical High
$251.19
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$47.86
Median
$134.90
Typical High
$363.08
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$112.20
Typical High
$177.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$181.97
Typical High
$251.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$125.89
Typical High
$223.87
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$165.96
Typical High
$229.09
Health New England
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$181.97
Typical High
$181.97
Health New England
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$181.97
Typical High
$275.42
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$85.11
Typical High
$144.54
United
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$141.25
Typical High
$251.19
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$138.04
Typical High
$251.19

Where Connecticut 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.

Connecticut· 37th of 51

$107

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.