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Office Visit, New Patient (Moderate Complexity)

Connecticut 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 $178 · 10th–90th $117$3090%20%10th90th$178Professionalmedian $170 · 10th–90th $95$3980%10%20%10th90th$170$1.0$5.0$20.0$100.0$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
$117.49
Median
$169.82
Typical High
$309.03
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$288.40
Median
$416.87
Typical High
$416.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$154.88
Typical High
$363.08
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$91.20
Median
$213.80
Typical High
$549.54
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$169.82
Typical High
$263.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$181.97
Typical High
$251.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$186.21
Typical High
$331.13
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$229.09
Typical High
$346.74
Health New England
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$181.97
Typical High
$257.04
Health New England
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$269.15
Typical High
$354.81
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$131.83
Typical High
$190.55
United
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$190.55
Typical High
$331.13
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$89.13
Median
$204.17
Typical High
$371.54