go back

Office Visit, New Patient (Moderate Complexity)

Montana 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 $224 · 10th–90th $129$3020%10%10th90th$224Professionalmedian $191 · 10th–90th $120$4900%10%10th90th$191$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
$47.86
Median
$204.17
Typical High
$489.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$190.55
Typical High
$467.74
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$112.20
Median
$190.55
Typical High
$549.54
BCBS
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$223.87
Typical High
$263.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$208.93
Typical High
$263.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$186.21
Typical High
$354.81
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$251.19
Typical High
$295.12
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$251.19
Typical High
$295.12
Providence
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$181.97
Typical High
$316.23
Providence
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$251.19
Typical High
$436.52
United
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$213.80
Typical High
$309.03
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$97.72
Typical High
$263.03