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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.

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

$195

Typical negotiated rate. In Oregon, July 2026.

Insurers have agreed to pay about $195 for this service. The price depends on where it is billed: about $195 from a physician practice, and about $224 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 9 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$195$151 to $295
FacilityA hospital or hospital-owned outpatient department$224$162 to $309

How much rates vary

Facilitymedian $224 · 10th to 90th $123 to $339Professionalmedian $195 · 10th to 90th $115 to $457
$50$100$200$500facility $224professional $195

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
$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

Where Oregon 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.

Oregon· 3rd of 51

$195

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.