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Office Visit, New Patient (Moderate Complexity)

Alabama 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.

Rates data updated July 2026.

Facilitymedian $110 · 10th–90th $81$1510%20%10th90th$110Professionalmedian $151 · 10th–90th $98$2950%10%10th90th$151$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
$81.28
Median
$109.65
Typical High
$144.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$141.25
Typical High
$269.15
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$102.33
Median
$173.78
Typical High
$323.59
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$162.18
Typical High
$229.09
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$131.83
Median
$165.96
Typical High
$223.87
BCBS
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$173.78
Typical High
$275.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$134.90
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$162.18
Typical High
$316.23
United
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$120.23
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$141.25
Typical High
$239.88
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$89.13
Typical High
$263.03