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Office Visit, Established Patient (Moderate Complexity)

Maryland 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?

$112

Typical negotiated rate. In Maryland, July 2026.

Insurers have agreed to pay about $112 for this service. The price depends on where it is billed: about $112 from a physician practice, and about $200 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$112$83.18 to $158
FacilityA hospital or hospital-owned outpatient department$200$87.10 to $282

How much rates vary

Facilitymedian $200 · 10th to 90th $66 to $490Professionalmedian $112 · 10th to 90th $60 to $257
$20$50$100$200$500facility $200professional $112

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
$66.07
Median
$223.87
Typical High
$489.78
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$97.72
Median
$154.88
Typical High
$162.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$112.20
Typical High
$263.03
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$58.88
Median
$131.83
Typical High
$302.00
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$74.13
Typical High
$117.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$144.54
Typical High
$186.21
Cigna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$114.82
Typical High
$186.21
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$144.54
Typical High
$204.17
United
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$85.11
Typical High
$169.82
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$104.71
Typical High
$190.55
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$128.82
Typical High
$251.19
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$131.83
Typical High
$199.53

Where Maryland 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.

Maryland· 29th of 51

$112

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.