go back

Office Visit, New Patient (Moderate Complexity)

Nevada 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 $158 · 10th–90th $98$2510%20%10th90th$158Professionalmedian $178 · 10th–90th $110$4370%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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$154.88
Typical High
$323.59
Aetna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$177.83
Typical High
$407.38
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$95.50
Median
$190.55
Typical High
$537.03
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$173.78
Typical High
$263.03
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$138.04
Median
$173.78
Typical High
$239.88
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$169.82
Typical High
$281.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$134.90
Typical High
$218.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$169.82
Typical High
$263.03
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$154.88
Typical High
$239.88
Hometown Health
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$660.69
Median
$660.69
Typical High
$660.69
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$263.03
Select Health
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$158.49
Typical High
$177.83
Select Health
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$120.23
Typical High
$218.78
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$131.83
Typical High
$251.19
United
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$162.18
Typical High
$275.42
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$85.11
Median
$173.78
Typical High
$323.59