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Office Visit, New Patient (Moderate Complexity)

Washington, DC 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 $302 · 10th–90th $129$3980%10%10th90th$302Professionalmedian $135 · 10th–90th $87$2040%10%10th90th$135$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
$128.82
Median
$302.00
Typical High
$398.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$134.90
Typical High
$199.53
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$32.36
Median
$134.90
Typical High
$269.15
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$112.20
Typical High
$151.36
Cigna
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$165.96
Typical High
$316.23
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$199.53
Typical High
$323.59
United
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$128.82
United
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$181.97
Typical High
$316.23
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$89.13
Typical High
$371.54