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Office Visit, Established Patient (Moderate Complexity)

Nebraska 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?

$123

Typical negotiated rate. In Nebraska, July 2026.

Insurers have agreed to pay about $123 for this service. The price depends on where it is billed: about $123 from a physician practice, and about $162 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$123$89.13 to $200
FacilityA hospital or hospital-owned outpatient department$162$120 to $229

How much rates vary

Facilitymedian $162 · 10th to 90th $98 to $513Professionalmedian $123 · 10th to 90th $68 to $245
$20$50$100$200$500facility $162professional $123

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
$120.23
Median
$190.55
Typical High
$616.60
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$275.42
Median
$724.44
Typical High
$933.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$120.23
Typical High
$239.88
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$58.88
Median
$123.03
Typical High
$245.47
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$147.91
Typical High
$257.04
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$102.33
Median
$165.96
Typical High
$257.04
BCBS
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$229.09
Typical High
$323.59
BCBS
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$165.96
Typical High
$239.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$151.36
Typical High
$165.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$158.49
Typical High
$302.00
Medica
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$125.89
Typical High
$213.80
Medica
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$194.98
Median
$194.98
Typical High
$275.42
Medica
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$234.42
Typical High
$316.23
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$177.83
Median
$223.87
Typical High
$288.40
Midlands
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$190.55
Typical High
$251.19
Midlands
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$190.55
Typical High
$288.40
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$331.13
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$134.90
Typical High
$229.09
United
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$141.25
Typical High
$177.83
United
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$134.90
Typical High
$257.04
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$158.49
Typical High
$204.17

Where Nebraska 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.

Nebraska· 16th of 51

$123

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.