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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.

How much does Office Visit, New Patient (Moderate Complexity) cost?

$151

Typical negotiated rate. In Oklahoma, July 2026.

Insurers have agreed to pay about $151 for this service. The price depends on where it is billed: about $148 from a physician practice, and about $162 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$148$126 to $182
FacilityA hospital or hospital-owned outpatient department$162$126 to $200

How much rates vary

Facilitymedian $162 · 10th to 90th $107 to $251Professionalmedian $148 · 10th to 90th $105 to $240
$50$100$200$500facility $162professional $148

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

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

Where Oklahoma sits

Rates are fairly even across states for this service. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Oklahoma· 42nd of 51

$151

MN $200DC $135

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.