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Office Visit, New Patient (Moderate Complexity)

Hawaii 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 $309 · 10th–90th $141$3720%20%10th90th$309Professionalmedian $182 · 10th–90th $112$5130%10%10th90th$182$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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
$112.20
Median
$309.03
Typical High
$371.54
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$177.83
Typical High
$446.68
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$100.00
Median
$194.98
Typical High
$575.44
Cigna
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$186.21
Typical High
$371.54
HMSA
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$36.31
Typical High
$44.67
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$186.21
Typical High
$257.04
United
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$141.25
United
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$162.18
Typical High
$239.88
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$89.13
Typical High
$323.59
University Health Alliance
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$223.87
Typical High
$338.84