go back

Office Visit, New Patient (Moderate Complexity)

Oregon 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 $224 · 10th–90th $123$3630%10%10th90th$224Professionalmedian $195 · 10th–90th $115$4680%10%10th90th$195$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$239.88
Typical High
$426.58
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$144.54
Median
$389.05
Typical High
$537.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$186.21
Typical High
$457.09
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$97.72
Median
$199.53
Typical High
$537.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$218.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$245.47
Typical High
$398.11
HealthNet
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$436.52
Typical High
$467.74
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$295.12
Typical High
$416.87
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$186.21
Typical High
$316.23
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$275.42
Typical High
$407.38
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$309.03
Typical High
$331.13
Providence
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$186.21
Typical High
$323.59
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$295.12
Typical High
$416.87
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$151.36
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$309.03
Typical High
$446.68
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$131.83
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$257.04
Typical High
$389.05
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$89.13
Typical High
$295.12