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Office Visit, New Patient (Moderate Complexity)

Delaware 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 $132 · 10th–90th $105$2000%20%10th90th$132Professionalmedian $145 · 10th–90th $98$2820%10%10th90th$145$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
$104.71
Median
$131.83
Typical High
$199.53
Aetna
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$134.90
Typical High
$239.88
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$158.49
Median
$229.09
Typical High
$537.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$131.83
Typical High
$199.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$165.96
Typical High
$269.15
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$199.53
Typical High
$295.12
Highmark BCBS
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$147.91
Median
$173.78
Typical High
$380.19
United
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$151.36
Typical High
$275.42
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$89.13
Median
$89.13
Typical High
$257.04