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Established Patient Office Visit, High Complexity

Florida 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 Florida, 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 $129 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 8 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$117 to $204
FacilityA hospital or hospital-owned outpatient department$129$110 to $288

How much rates vary

Facilitymedian $129 · 10th to 90th $89 to $398Professionalmedian $148 · 10th to 90th $95 to $331
$50$100$200$500$1Kfacility $129professional $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
$89.13
Median
$128.82
Typical High
$398.11
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$234.42
Median
$338.84
Typical High
$758.58
Aetna
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$147.91
Typical High
$338.84
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$89.13
Median
$204.17
Typical High
$407.38
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$177.83
Typical High
$263.03
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$141.25
Median
$186.21
Typical High
$275.42
AvMed
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$131.83
Typical High
$144.54
AvMed
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$141.25
Typical High
$199.53
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$177.83
Typical High
$426.58
Cigna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$169.82
Typical High
$295.12
Florida Blue
Setting
Facility
Modifier
Global
Typical Low
$30.20
Median
$263.03
Typical High
$416.87
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$138.04
Typical High
$223.87
Molina
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$120.23
Typical High
$218.78
United
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$141.25
Typical High
$223.87
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$141.25
Typical High
$288.40
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$95.50
Typical High
$346.74
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$93.33
Typical High
$190.55

Where Florida 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.

Florida· 36th 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.