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Office Visit, New Patient (Moderate Complexity)

Maryland 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 $204 · 10th–90th $105$4790%5%10%10th90th$204Professionalmedian $174 · 10th–90th $102$3890%5%10%10th90th$174$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
$104.71
Median
$245.47
Typical High
$478.63
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$104.71
Median
$104.71
Typical High
$104.71
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$169.82
Typical High
$363.08
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$95.50
Median
$194.98
Typical High
$501.19
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$114.82
Typical High
$169.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$144.54
Typical High
$186.21
Cigna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$169.82
Typical High
$275.42
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$186.21
Typical High
$269.15
United
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$128.82
Typical High
$169.82
United
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$162.18
Typical High
$288.40
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$97.72
Typical High
$354.81
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$173.78
Typical High
$257.04