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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.

Facilitymedian $200 · 10th–90th $69$5750%10%10th90th$200Professionalmedian $178 · 10th–90th $110$3390%5%10%10th90th$178$1.0$5.0$20.0$100.0$500.0

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
$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