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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.

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

$182

Typical negotiated rate. In North Dakota, July 2026.

Insurers have agreed to pay about $182 for this service. The price depends on where it is billed: about $182 from a physician practice, and about $129 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 4 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$182$138 to $282
FacilityA hospital or hospital-owned outpatient department$129$115 to $155

How much rates vary

Facilitymedian $129 · 10th to 90th $51 to $224Professionalmedian $182 · 10th to 90th $110 to $398
$50$100$200$500facility $129professional $182

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
$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

Where North Dakota 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.

North Dakota· 10th of 51

$182

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.