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Office Visit, New Patient (Moderate Complexity)

Arkansas 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 $141 · 10th–90th $110$1820%20%10th90th$141Professionalmedian $155 · 10th–90th $105$2690%10%10th90th$155$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
$109.65
Median
$138.04
Typical High
$181.97
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$389.05
Median
$389.05
Typical High
$389.05
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$151.36
Typical High
$263.03
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$104.71
Median
$173.78
Typical High
$309.03
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$165.96
Typical High
$208.93
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$125.89
Median
$173.78
Typical High
$208.93
BCBS
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$173.78
BCBS
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$154.88
Typical High
$204.17
CareSource
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$158.49
Typical High
$177.83
CareSource
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$213.80
Typical High
$251.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$134.90
Typical High
$169.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$162.18
Typical High
$263.03
Qualchoice
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$194.98
Typical High
$245.47
Qualchoice
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$173.78
Median
$208.93
Typical High
$251.19
United
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$141.25
Typical High
$257.04
United
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$154.88
Typical High
$234.42
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$97.72
Typical High
$354.81