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Office Visit, New Patient (Moderate Complexity)

Minnesota 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.

Facilitymedian $170 · 10th–90th $89$5500%5%10%10th90th$170Professionalmedian $204 · 10th–90th $110$4470%5%10th90th$204$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
$69.18
Median
$128.82
Typical High
$380.19
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$380.19
Median
$380.19
Typical High
$645.65
Aetna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$173.78
Typical High
$398.11
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$114.82
Median
$204.17
Typical High
$446.68
BCBS
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$245.47
Typical High
$1,445.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$354.81
Typical High
$501.19
BCBS
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$165.96
Median
$288.40
Typical High
$398.11
Cigna
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$537.03
Typical High
$1,479.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$331.13
Typical High
$588.84
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$602.56
Typical High
$1,174.90
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$338.84
Typical High
$537.03
Medica
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$181.97
Typical High
$371.54
Medica
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$354.81
Median
$354.81
Typical High
$575.44
Medica
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$426.58
Typical High
$524.81
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$309.03
Median
$426.58
Typical High
$501.19
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$131.83
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$269.15
Typical High
$446.68
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$85.11
Median
$97.72
Typical High
$371.54