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Office Visit, Established Patient (Moderate Complexity)

Florida 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?

$105

Typical negotiated rate. In Florida, July 2026.

Insurers have agreed to pay about $105 for this service. The price depends on where it is billed: about $105 from a physician practice, and about $95.50 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 8 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$105$83.18 to $151
FacilityA hospital or hospital-owned outpatient department$95.50$81.28 to $209

How much rates vary

Facilitymedian $95 · 10th to 90th $63 to $295Professionalmedian $105 · 10th to 90th $66 to $251
$20$50$100$200$500facility $95professional $105

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
$63.10
Median
$95.50
Typical High
$295.12
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$114.82
Median
$331.13
Typical High
$645.65
Aetna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$104.71
Typical High
$251.19
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$60.26
Median
$120.23
Typical High
$275.42
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$123.03
Typical High
$173.78
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$89.13
Median
$128.82
Typical High
$181.97
AvMed
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$93.33
Typical High
$102.33
AvMed
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$102.33
Typical High
$141.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$147.91
Typical High
$223.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$120.23
Typical High
$213.80
Florida Blue
Setting
Facility
Modifier
Global
Typical Low
$30.20
Median
$263.03
Typical High
$416.87
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$107.15
Typical High
$186.21
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$58.88
Typical High
$128.82
United
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$125.89
Typical High
$177.83
United
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$100.00
Typical High
$204.17
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$75.86
Median
$131.83
Typical High
$194.98
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$53.70
Typical High
$134.90

Where Florida 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.

Florida· 38th of 51

$105

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.