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Established Patient Office Visit, High Complexity

Colorado 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?

$148

Typical negotiated rate. In Colorado, July 2026.

Insurers have agreed to pay about $148 for this service. The price depends on where it is billed: about $148 from a physician practice, and about $166 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$148$120 to $200
FacilityA hospital or hospital-owned outpatient department$166$129 to $229

How much rates vary

Facilitymedian $166 · 10th to 90th $95 to $372Professionalmedian $148 · 10th to 90th $95 to $339
$50$100$200$500$1Kfacility $166professional $148

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
$74.13
Median
$154.88
Typical High
$588.84
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$85.11
Median
$181.97
Typical High
$1,047.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$144.54
Typical High
$346.74
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$81.28
Median
$190.55
Typical High
$457.09
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$158.49
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$190.55
Typical High
$295.12
Cigna
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$151.36
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$181.97
Typical High
$302.00
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$169.82
Typical High
$275.42
Denver HMP
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$269.15
Typical High
$501.19
Select Health
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Select Health
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$169.82
Typical High
$223.87
United
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$186.21
Typical High
$331.13
United
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$169.82
Typical High
$302.00
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$151.36
Typical High
$338.84

Where Colorado 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.

Colorado· 35th of 51

$148

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.