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Established Patient Office Visit, High Complexity

Delaware 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?

$129

Typical physician fee. In Delaware, July 2026.

Insurers have agreed to pay about $129 for this service. Most negotiated rates run $112 to $162.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $141 · 10th to 90th $115 to $331Professionalmedian $129 · 10th to 90th $93 to $269
$100$200$500facility $141professional $129

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
$114.82
Median
$141.25
Typical High
$331.13
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$338.84
Median
$489.78
Typical High
$537.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$128.82
Typical High
$269.15
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$125.89
Median
$190.55
Typical High
$537.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$131.83
Typical High
$199.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$151.36
Typical High
$281.84
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$213.80
Typical High
$338.84
Highmark BCBS
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$158.49
Median
$186.21
Typical High
$309.03
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$134.90
Typical High
$257.04
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$89.13
Median
$89.13
Typical High
$89.13

Where Delaware 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.

Delaware· 50th of 51

$129

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.