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Office Visit, New Patient (Moderate Complexity)

Alaska rates for HCPCS 99204

An initial appointment with a doctor or provider the patient has not seen before, involving a moderate level of medical decision-making, such as reviewing several health concerns or evaluating a condition that needs a closer look. First visits like this typically involve more time than a follow-up because the provider is building a full picture of the patient's health history for the first time. It reflects a meaningful step up in complexity from the most basic new-patient visit.

Facilitymedian $204 · 10th–90th $115$3890%10%10th90th$204Professionalmedian $170 · 10th–90th $107$3980%10%10th90th$170$10.0$50.0$200.0$1.0K

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
$234.42
Median
$323.59
Typical High
$478.63
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$316.23
Median
$323.59
Typical High
$354.81
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$162.18
Typical High
$354.81
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$125.89
Median
$199.53
Typical High
$436.52
Cigna
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$218.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$194.98
Typical High
$457.09
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$199.53
Typical High
$371.54
Moda Health
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$316.23
Median
$323.59
Typical High
$354.81
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$257.04
Typical High
$549.54
Moda Health
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$128.82
Median
$213.80
Typical High
$478.63
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$3,467.37
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$398.11
Typical High
$478.63
Providence
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$186.21
Typical High
$338.84
Providence
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$245.47
Typical High
$446.68
United
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$218.78
Typical High
$489.78
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$89.13
Median
$89.13
Typical High
$371.54