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Established Patient Office Visit, High Complexity

Arizona 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?

$170

Typical negotiated rate. In Arizona, July 2026.

Insurers have agreed to pay about $170 for this service. The price depends on where it is billed: about $170 from a physician practice, and about $174 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 6 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$170$126 to $240
FacilityA hospital or hospital-owned outpatient department$174$135 to $302

How much rates vary

Facilitymedian $174 · 10th to 90th $110 to $525Professionalmedian $170 · 10th to 90th $98 to $437
$50$100$200$500$1Kfacility $174professional $170

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
$245.47
Median
$331.13
Typical High
$1,819.70
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$1,148.15
Median
$1,819.70
Typical High
$2,041.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$169.82
Typical High
$436.52
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$83.18
Median
$199.53
Typical High
$512.86
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$173.78
Typical High
$239.88
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$131.83
Median
$181.97
Typical High
$239.88
BCBS
Setting
Facility
Modifier
Global
Typical Low
$26.92
Median
$26.92
Typical High
$26.92
BCBS
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$134.90
Typical High
$194.98
Cigna
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$109.65
Typical High
$234.42
Cigna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$154.88
Typical High
$295.12
Medica
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$151.36
Typical High
$251.19
Medica
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$190.55
Typical High
$1,122.02
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$123.03
Median
$263.03
Typical High
$380.19
United
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$109.65
Typical High
$223.87
United
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$138.04
Typical High
$269.15
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$95.50
Typical High
$338.84

Where Arizona 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.

Arizona· 16th of 51

$170

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.