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Established Patient Office Visit, High Complexity

North Dakota 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?

$178

Typical negotiated rate. In North Dakota, July 2026.

Insurers have agreed to pay about $178 for this service. The price depends on where it is billed: about $178 from a physician practice, and about $135 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 4 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$178$132 to $331
FacilityA hospital or hospital-owned outpatient department$135$110 to $309

How much rates vary

Facilitymedian $135 · 10th to 90th $37 to $331Professionalmedian $178 · 10th to 90th $110 to $479
$10$20$50$100$200$500facility $135professional $178

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
$24.55
Median
$131.83
Typical High
$467.74
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$316.23
Median
$316.23
Typical High
$316.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$173.78
Typical High
$478.63
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$109.65
Median
$213.80
Typical High
$489.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$275.42
Typical High
$446.68
Medica
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$173.78
Typical High
$309.03
Medica
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$323.59
Typical High
$912.01
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$269.15
Median
$363.08
Typical High
$467.74
United
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$223.87
Typical High
$223.87
United
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$208.93
Typical High
$354.81
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$346.74
Median
$346.74
Typical High
$407.38

Where North Dakota 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.

North Dakota· 11th of 51

$178

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.