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Office Visit, Established Patient (Moderate Complexity)

Idaho 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?

$135

Typical negotiated rate. In Idaho, July 2026.

Insurers have agreed to pay about $135 for this service. The price depends on where it is billed: about $135 from a physician practice, and about $126 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$135$97.72 to $200
FacilityA hospital or hospital-owned outpatient department$126$81.28 to $162

How much rates vary

Facilitymedian $126 · 10th to 90th $56 to $204Professionalmedian $135 · 10th to 90th $74 to $347
$10$20$50$100$200$500facility $126professional $135

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
$26.30
Median
$125.89
Typical High
$199.53
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$61.66
Median
$144.54
Typical High
$204.17
Aetna
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$134.90
Typical High
$354.81
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$64.57
Median
$138.04
Typical High
$380.19
BCBS
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$79.43
BCBS
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$194.98
Typical High
$263.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$165.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$138.04
Typical High
$223.87
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$125.89
Typical High
$208.93
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$177.83
Typical High
$269.15
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$251.19
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$162.18
Typical High
$251.19
Select Health
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$61.66
Typical High
$131.83
Select Health
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$151.36
Typical High
$281.84
United
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$158.49
United
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$128.82
Typical High
$204.17
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$89.13
Typical High
$181.97

Where Idaho 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.

Idaho· 2nd of 51

$135

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.