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Office Visit, Established Patient (Moderate Complexity)

Washington, DC 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?

$89.13

Typical negotiated rate. In Washington, DC, July 2026.

Insurers have agreed to pay about $89.13 for this service. The price depends on where it is billed: about $89.13 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 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$89.13$67.61 to $110
FacilityA hospital or hospital-owned outpatient department$195$138 to $245

How much rates vary

Facilitymedian $195 · 10th to 90th $123 to $275Professionalmedian $89 · 10th to 90th $45 to $141
$20$50$100$200facility $195professional $89

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
$128.82
Median
$194.98
Typical High
$275.42
Aetna
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$87.10
Typical High
$138.04
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$24.55
Median
$81.28
Typical High
$229.09
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$74.13
Typical High
$181.97
Cigna
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$112.20
Typical High
$213.80
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$151.36
Typical High
$218.78
United
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$85.11
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$117.49
Typical High
$218.78
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$89.13
Typical High
$181.97

Where Washington, DC 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.

Washington, DC· 51st of 51

$89.13

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.