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Office Visit, New Patient (Moderate Complexity)

New Hampshire 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?

$178

Typical negotiated rate. In New Hampshire, July 2026.

Insurers have agreed to pay about $178 for this service. The price depends on where it is billed: about $178 from a physician practice, and about $200 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 8 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$178$132 to $257
FacilityA hospital or hospital-owned outpatient department$200$151 to $282

How much rates vary

Facilitymedian $200 · 10th to 90th $69 to $447Professionalmedian $178 · 10th to 90th $110 to $331
$50$100$200$500$1Kfacility $200professional $178

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
$69.18
Median
$199.53
Typical High
$354.81
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$51.29
Median
$269.15
Typical High
$758.58
Aetna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$154.88
Typical High
$302.00
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$81.28
Median
$190.55
Typical High
$346.74
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$173.78
Typical High
$251.19
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$134.90
Median
$177.83
Typical High
$363.08
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$1,000.00
Typical High
$1,000.00
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$263.03
Typical High
$323.59
Cigna
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$173.78
Typical High
$199.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$208.93
Typical High
$354.81
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$234.42
Typical High
$407.38
Optum
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$316.23
Typical High
$407.38
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$131.83
United
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$229.09
Typical High
$416.87
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$89.13
Typical High
$371.54
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$120.23
Typical High
$181.97

Where New Hampshire 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.

New Hampshire· 13th of 51

$178

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.