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Established Patient Office Visit, High Complexity

New Hampshire 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 New Hampshire, 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 $186 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$174$129 to $245
FacilityA hospital or hospital-owned outpatient department$186$135 to $263

How much rates vary

Facilitymedian $186 · 10th to 90th $117 to $741Professionalmedian $174 · 10th to 90th $98 to $324
$50$100$200$500$1Kfacility $186professional $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
$125.89
Median
$186.21
Typical High
$426.58
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$154.88
Median
$234.42
Typical High
$707.95
Aetna
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$144.54
Typical High
$281.84
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$75.86
Median
$165.96
Typical High
$288.40
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$190.55
Typical High
$275.42
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$151.36
Median
$194.98
Typical High
$416.87
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$1,659.59
Typical High
$1,659.59
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$239.88
Typical High
$295.12
Cigna
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$173.78
Typical High
$199.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$208.93
Typical High
$363.08
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$251.19
Typical High
$436.52
Optum
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$239.88
Typical High
$323.59
United
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$223.87
Typical High
$426.58
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$89.13
Median
$141.25
Typical High
$407.38
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$125.89
Typical High
$190.55

Where New Hampshire 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.

New Hampshire· 12th 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.