Office visit established patient moderate complexity
CPT 99214 • Office Visits
If you're paying cash
$84 – $284
Posted cash price at 6 hospitals in North Carolina. Hospitals must publish these; ask for the self-pay or cash price by name when you call.
See what your plan negotiated
Lowest
$4
Typical
$125
Highest
$834
203,166 negotiated rates from NC hospitals. These are what insurers pay, not what you would be billed.
About this procedure
An established-patient office visit (level 4) — a more involved 25-minute appointment for a moderately complex problem like managing diabetes or a new symptom requiring workup.
What to expect
Longer than a 99213 visit; the provider documents more detail and your concern requires more thinking through. Often the right code for a follow-up after a hospital stay or when starting a new medication. Cost is 30-50% higher than a 99213.