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Office Visit, Established Patient (Moderate Complexity)

Oregon 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 Oregon, 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 $155 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 9 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$95.50 to $195
FacilityA hospital or hospital-owned outpatient department$155$110 to $219

How much rates vary

Facilitymedian $155 · 10th to 90th $83 to $263Professionalmedian $135 · 10th to 90th $68 to $324
$20$50$100$200$500facility $155professional $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
$93.33
Median
$223.87
Typical High
$812.83
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$316.23
Typical High
$602.56
Aetna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$131.83
Typical High
$323.59
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$60.26
Median
$134.90
Typical High
$354.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$181.97
Cigna
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$173.78
Typical High
$295.12
HealthNet
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$275.42
Typical High
$354.81
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$213.80
Typical High
$323.59
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$128.82
Typical High
$218.78
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$186.21
Typical High
$309.03
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$204.17
Typical High
$251.19
Providence
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$125.89
Typical High
$218.78
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$204.17
Typical High
$316.23
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$97.72
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$229.09
Typical High
$331.13
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$158.49
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$162.18
Typical High
$257.04
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$75.86
Median
$125.89
Typical High
$181.97

Where Oregon 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.

Oregon· 5th 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.