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New Patient Office Visit, Straightforward

Pennsylvania rates for HCPCS 99201

A first visit at an office or clinic with a clinician who has not seen you before. It covers a short, uncomplicated visit for a minor problem, with a brief history, a limited examination and simple decision-making. Longer versions of the same visit are used when the problem is more involved.

Rates data updated July 2026.

How much does New Patient Office Visit, Straightforward cost?

$36.31

Typical physician fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $36.31 for this service. Most negotiated rates run $33.88 to $41.69.

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 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $34 · 10th to 90th $34 to $40Professionalmedian $36 · 10th to 90th $32 to $72
$50$100facility $34professional $36

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$102.33
Typical High
$181.97
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$33.88
Typical High
$39.81
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$35.48
Typical High
$53.70
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$39.81
Typical High
$91.20

Where Pennsylvania sits

The same service costs 7.2 times more in Kentucky than in South Carolina. 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.

Pennsylvania· 46th of 47

$36.31

KY $219SC $30.20

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.