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Office Visit, Established Patient (Moderate Complexity)

Delaware 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?

$97.72

Typical physician fee. In Delaware, July 2026.

Insurers have agreed to pay about $97.72 for this service. Most negotiated rates run $79.43 to $132.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $115 · 10th to 90th $76 to $437Professionalmedian $98 · 10th to 90th $65 to $200
$50$100$200$500facility $115professional $98

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
$75.86
Median
$114.82
Typical High
$436.52
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$54.95
Median
$354.81
Typical High
$389.05
Aetna
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$97.72
Typical High
$199.53
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$50.12
Median
$134.90
Typical High
$223.87
Cigna
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$131.83
Typical High
$199.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$109.65
Typical High
$194.98
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$177.83
Typical High
$251.19
Highmark BCBS
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$125.89
Median
$138.04
Typical High
$245.47
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$100.00
Typical High
$190.55
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$85.11
Median
$89.13
Typical High
$147.91

Where Delaware 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.

Delaware· 50th of 51

$97.72

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.