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Established Patient Office Visit, High Complexity

Hawaii 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?

$174

Typical negotiated rate. In Hawaii, July 2026.

Insurers have agreed to pay about $174 for this service. The price depends on where it is billed: about $174 from a physician practice, and about $288 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$174$126 to $251
FacilityA hospital or hospital-owned outpatient department$288$229 to $324

How much rates vary

Facilitymedian $288 · 10th to 90th $68 to $372Professionalmedian $174 · 10th to 90th $95 to $468
$50$100$200$500facility $288professional $174

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
$67.61
Median
$288.40
Typical High
$371.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$173.78
Typical High
$478.63
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$81.28
Median
$199.53
Typical High
$537.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$173.78
Typical High
$389.05
HMSA
Setting
Professional
Modifier
Global
Typical Low
$18.20
Median
$28.18
Typical High
$33.88
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$204.17
Typical High
$281.84
United
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$141.25
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$151.36
Typical High
$245.47
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$89.13
Typical High
$346.74
University Health Alliance
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$213.80
Typical High
$371.54

Where Hawaii 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.

Hawaii· 14th of 51

$174

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.