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Established Patient Office Visit, High Complexity

Minnesota 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?

$219

Typical negotiated rate. In Minnesota, July 2026.

Insurers have agreed to pay about $219 for this service. The price depends on where it is billed: about $219 from a physician practice, and about $178 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$219$138 to $380
FacilityA hospital or hospital-owned outpatient department$178$129 to $339

How much rates vary

Facilitymedian $178 · 10th to 90th $98 to $550Professionalmedian $219 · 10th to 90th $112 to $501
$10$20$50$100$200$500$1Kfacility $178professional $219

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
$37.15
Median
$141.25
Typical High
$467.74
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$316.23
Median
$512.86
Typical High
$912.01
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$173.78
Typical High
$478.63
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$109.65
Median
$213.80
Typical High
$501.19
BCBS
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$263.03
Typical High
$1,548.82
BCBS
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$380.19
Typical High
$501.19
BCBS
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$177.83
Median
$302.00
Typical High
$407.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$562.34
Typical High
$1,778.28
Cigna
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$354.81
Typical High
$630.96
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$724.44
Typical High
$1,412.54
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$380.19
Typical High
$602.56
Medica
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$177.83
Typical High
$398.11
Medica
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
Medica
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$426.58
Typical High
$562.34
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$316.23
Median
$426.58
Typical High
$562.34
United
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$223.87
United
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$257.04
Typical High
$436.52
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$89.13
Median
$194.98
Typical High
$407.38

Where Minnesota 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.

Minnesota· 1st of 51

$219

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.