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Office Visit, Established Patient (Moderate Complexity)

Missouri 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?

$117

Typical negotiated rate. In Missouri, July 2026.

Insurers have agreed to pay about $117 for this service. The price depends on where it is billed: about $117 from a physician practice, and about $123 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$117$85.11 to $158
FacilityA hospital or hospital-owned outpatient department$123$91.20 to $209

How much rates vary

Facilitymedian $123 · 10th to 90th $76 to $339Professionalmedian $117 · 10th to 90th $63 to $240
$20$50$100$200$500facility $123professional $117

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
$125.89
Typical High
$457.09
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$95.50
Median
$323.59
Typical High
$501.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$117.49
Typical High
$245.47
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$56.23
Median
$123.03
Typical High
$288.40
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$123.03
Typical High
$173.78
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$93.33
Median
$128.82
Typical High
$173.78
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$104.71
Typical High
$151.36
BCBS
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$125.89
Typical High
$162.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$144.54
Typical High
$199.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$117.49
Typical High
$194.98
Medica
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$114.82
Typical High
$208.93
Medica
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$25.12
Median
$25.12
Typical High
$537.03
Medica
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$147.91
Typical High
$794.33
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$109.65
Median
$138.04
Typical High
$181.97
Qualchoice
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$144.54
Typical High
$190.55
Qualchoice
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$91.20
Median
$141.25
Typical High
$186.21
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$138.04
Typical High
$162.18
United
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$102.33
Typical High
$190.55
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$89.13
Typical High
$199.53

Where Missouri 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.

Missouri· 25th of 51

$117

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.