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New Mexico 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 $166 · 10th–90th $115–$2750%10%10th90th$166Professionalmedian $170 · 10th–90th $105–$4270%10%10th90th$170$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $151.36 / $275.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $162.18 / $380.19
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$114.82 / $194.98 / $537.03
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $138.04 / $199.53
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$107.15 / $158.49 / $186.21
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $147.91 / $194.98
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $147.91 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $186.21 / $269.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $239.88
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $173.78 / $281.84
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $199.53 / $354.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $177.83 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $186.21 / $295.12
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$89.13 / $181.97 / $323.59