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Office Visit, New Patient (Moderate Complexity)

North Dakota 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 $129 · 10th–90th $50$2880%20%10th90th$129Professionalmedian $191 · 10th–90th $112$4170%5%10%10th90th$191$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
$51.29
Median
$128.82
Typical High
$162.18
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$23.99
Median
$23.99
Typical High
$380.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$181.97
Typical High
$398.11
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$117.49
Median
$204.17
Typical High
$446.68
Cigna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$251.19
Typical High
$416.87
Medica
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$173.78
Typical High
$302.00
Medica
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$323.59
Typical High
$831.76
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$251.19
Median
$331.13
Typical High
$426.58
United
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$218.78
Typical High
$389.05
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$257.04
Typical High
$371.54