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Office Visit, New Patient (Moderate Complexity)

Kansas 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 $135 · 10th–90th $79$2510%10%10th90th$135Professionalmedian $155 · 10th–90th $98$2340%10%10th90th$155$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
$66.07
Median
$114.82
Typical High
$186.21
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$218.78
Median
$446.68
Typical High
$446.68
Aetna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$144.54
Typical High
$213.80
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$81.28
Median
$158.49
Typical High
$263.03
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$165.96
Typical High
$218.78
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$128.82
Median
$165.96
Typical High
$218.78
BCBS
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$100.00
Typical High
$100.00
BCBS
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$169.82
Typical High
$213.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$158.49
Typical High
$199.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$173.78
Typical High
$281.84
Medica
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$154.88
Typical High
$269.15
Medica
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$213.80
Typical High
$1,047.13
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$181.97
Median
$251.19
Typical High
$323.59
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$128.82
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$165.96
Typical High
$257.04
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$89.13
Typical High
$257.04