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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.

How much does Office Visit, New Patient (Moderate Complexity) cost?

$178

Typical negotiated rate. In Hawaii, July 2026.

Insurers have agreed to pay about $178 for this service. The price depends on where it is billed: about $178 from a physician practice, and about $309 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$178$145 to $263
FacilityA hospital or hospital-owned outpatient department$309$269 to $331

How much rates vary

Facilitymedian $309 · 10th to 90th $112 to $372Professionalmedian $178 · 10th to 90th $112 to $447
$50$100$200$500facility $309professional $178

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

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

Where Hawaii sits

Rates are fairly even across states for this service. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Hawaii· 14th of 51

$178

MN $200DC $135

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.