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New Patient Office Visit, Low Complexity

Utah rates for HCPCS 99203

This covers an office visit with a doctor or other provider for a patient who hasn't been seen by that practice, or a same-specialty colleague, within the past three years, involving a straightforward degree of medical decision-making. It's a moderate step up from the most basic new-patient check-in, but simpler than a visit for a complicated or multiple-problem case. How straightforward or involved the visit is depends on either the complexity of the medical decisions made or, alternatively, the total time the provider spends with the patient that day.

Facilitymedian $155 · 10th–90th $76$2290%20%10th90th$155Professionalmedian $123 · 10th–90th $66$3550%5%10%10th90th$123$5.0$10.0$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$17.38
Median
$120.23
Typical High
$229.09
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$213.80
Median
$218.78
Typical High
$218.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$120.23
Typical High
$354.81
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$67.61
Median
$125.89
Typical High
$346.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$147.91
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$114.82
Typical High
$208.93
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$128.82
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$117.49
Typical High
$169.82
Select Health
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$131.83
Typical High
$281.84
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$131.83
Typical High
$234.42
United
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$138.04
United
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$107.15
Typical High
$173.78
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$60.26
Median
$95.50
Typical High
$158.49