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Established Patient Office Visit, High Complexity

Arkansas rates for HCPCS 99215

This is the most involved type of office visit for a patient who has already been seen by that practice, used when the medical decision-making is complex, such as managing multiple serious conditions or higher-risk treatment decisions. It reflects a high degree of complexity in the medical decisions made, or a longer amount of time spent with the patient during that visit. It differs from more routine follow-up visits mainly by that greater complexity or time.

Rates data updated July 2026.

How much does Established Patient Office Visit, High Complexity cost?

$141

Typical negotiated rate. In Arkansas, July 2026.

Insurers have agreed to pay about $141 for this service. The price depends on where it is billed: about $141 from a physician practice, and about $135 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$141$120 to $174
FacilityA hospital or hospital-owned outpatient department$135$120 to $155

How much rates vary

Facilitymedian $135 · 10th to 90th $107 to $158Professionalmedian $141 · 10th to 90th $105 to $245
$50$100$200$500facility $135professional $141

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
$107.15
Median
$125.89
Typical High
$154.88
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$162.18
Median
$218.78
Typical High
$218.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$141.25
Typical High
$245.47
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$95.50
Median
$173.78
Typical High
$288.40
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$173.78
Typical High
$218.78
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$131.83
Median
$181.97
Typical High
$223.87
BCBS
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$199.53
BCBS
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$144.54
Typical High
$190.55
CareSource
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$169.82
Typical High
$194.98
CareSource
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$229.09
Typical High
$275.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$128.82
Typical High
$169.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$154.88
Typical High
$251.19
Qualchoice
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$204.17
Typical High
$269.15
Qualchoice
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$165.96
Median
$213.80
Typical High
$275.42
United
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$151.36
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$138.04
Typical High
$229.09
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$89.13
Median
$89.13
Typical High
$89.13

Where Arkansas sits

The same service costs 1.8 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.

Arkansas· 46th of 51

$141

MN $219DC $123

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.