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Office Visit, New Patient (Moderate Complexity)

New Mexico 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 $166 · 10th–90th $115$2750%10%10th90th$166Professionalmedian $174 · 10th–90th $110$4370%5%10%10th90th$174$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$151.36
Typical High
$218.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$173.78
Typical High
$416.87
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$112.20
Median
$204.17
Typical High
$549.54
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$147.91
Typical High
$223.87
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$102.33
Median
$158.49
Typical High
$199.53
BCBS
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$147.91
Typical High
$194.98
Cigna
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$147.91
Typical High
$173.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$186.21
Typical High
$269.15
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$251.19
Providence
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$173.78
Typical High
$281.84
Providence
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$199.53
Typical High
$354.81
United
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$158.49
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$186.21
Typical High
$323.59
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$89.13
Median
$177.83
Typical High
$323.59