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Office Visit, Established Patient (Moderate Complexity)

Utah 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?

$126

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $126 for this service. The price depends on where it is billed: about $126 from a physician practice, and about $288 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 7 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$126$91.20 to $174
FacilityA hospital or hospital-owned outpatient department$288$251 to $309

How much rates vary

Facilitymedian $288 · 10th to 90th $105 to $309Professionalmedian $126 · 10th to 90th $50 to $316
$20$50$100$200$500facility $288professional $126

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
$104.71
Median
$288.40
Typical High
$309.03
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$162.18
Median
$467.74
Typical High
$467.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$125.89
Typical High
$316.23
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$56.23
Median
$123.03
Typical High
$288.40
Cigna
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$165.96
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$120.23
Typical High
$218.78
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$154.88
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$131.83
Typical High
$190.55
Select Health
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$147.91
Select Health
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$128.82
Typical High
$309.03
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$141.25
Typical High
$263.03
United
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$199.53
United
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$109.65
Typical High
$181.97
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$89.13
Typical High
$158.49

Where Utah 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.

Utah· 12th of 51

$126

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.