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New Hampshire rates for HCPCS 99204

Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.

Facilitymedian $145 · 10th–90th $126–$4470%20%40%10th90th$145Professionalmedian $182 · 10th–90th $107–$3890%10%20%10th90th$182$1.0$5.0$20.0$100.0$500.0$2.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $154.88 / $446.68
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$134.90 / $134.90 / $177.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $165.96 / $380.19
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$125.89 / $208.93 / $436.52
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $173.78 / $251.19
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$147.91 / $177.83 / $389.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $1,000.00 / $1,000.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $251.19 / $316.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $173.78 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $208.93 / $338.84
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $234.42 / $407.38
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $316.23 / $407.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $131.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $229.09 / $416.87
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $89.13 / $371.54
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $120.23 / $181.97