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Office Visit, New Patient (Moderate Complexity)

Oklahoma 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 $107$2570%10%10th90th$166Professionalmedian $155 · 10th–90th $105$2570%10%10th90th$155$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
$107.15
Median
$158.49
Typical High
$229.09
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$363.08
Median
$363.08
Typical High
$363.08
Aetna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$144.54
Typical High
$245.47
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$83.18
Median
$169.82
Typical High
$338.84
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$165.96
Typical High
$234.42
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$123.03
Median
$165.96
Typical High
$223.87
BCBS
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$158.49
Typical High
$218.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$120.23
Typical High
$144.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$165.96
Typical High
$245.47
Medica
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$165.96
Typical High
$263.03
Medica
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$190.55
Typical High
$1,047.13
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$138.04
Median
$165.96
Typical High
$204.17
United
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$131.83
Typical High
$257.04
United
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$151.36
Typical High
$223.87
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$89.13
Typical High
$263.03