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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.

Rates data updated July 2026.

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

$200

Typical negotiated rate. In Minnesota, July 2026.

Insurers have agreed to pay about $200 for this service. The price depends on where it is billed: about $200 from a physician practice, and about $155 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$200$145 to $347
FacilityA hospital or hospital-owned outpatient department$155$120 to $324

How much rates vary

Facilitymedian $155 · 10th to 90th $102 to $646Professionalmedian $200 · 10th to 90th $112 to $468
$50$100$200$500$1Kfacility $155professional $200

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
$91.20
Median
$131.83
Typical High
$380.19
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$23.99
Median
$380.19
Typical High
$380.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$177.83
Typical High
$436.52
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$107.15
Median
$204.17
Typical High
$501.19
BCBS
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$245.47
Typical High
$1,445.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$354.81
Typical High
$489.78
BCBS
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$162.18
Median
$281.84
Typical High
$398.11
Cigna
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$524.81
Typical High
$1,659.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$331.13
Typical High
$575.44
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$660.69
Typical High
$1,318.26
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$354.81
Typical High
$549.54
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
$120.23
Median
$288.40
Typical High
$446.68
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$85.11
Median
$97.72
Typical High
$371.54

Where Minnesota 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.

Minnesota· 1st of 51

$200

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.