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Office Visit, New Patient (Moderate Complexity)

Louisiana 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 $155 · 10th–90th $126$2000%20%10th90th$155Professionalmedian $158 · 10th–90th $102$3470%10%10th90th$158$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
$125.89
Median
$158.49
Typical High
$239.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$154.88
Typical High
$338.84
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$91.20
Median
$173.78
Typical High
$501.19
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$162.18
Typical High
$218.78
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$131.83
Median
$165.96
Typical High
$229.09
BCBS
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$229.09
BCBS
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$151.36
Typical High
$181.97
Christus
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$134.90
Typical High
$158.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$151.36
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$158.49
Typical High
$309.03
United
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$141.25
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$151.36
Typical High
$239.88
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$181.97
Typical High
$371.54