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Office Visit, New Patient (High Complexity)

Alabama rates for HCPCS 99205

An initial, in-depth appointment with a doctor or provider the patient has not seen before, involving a high level of medical decision-making, such as managing multiple serious conditions or health issues that carry significant risk. It's the most involved level of a first-time office visit and typically takes considerably more time than a routine new-patient appointment. It reflects the most complex end of new-patient evaluations.

Rates data updated July 2026.

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

$178

Typical negotiated rate. In Alabama, July 2026.

Insurers have agreed to pay about $178 for this service. The price depends on where it is billed: about $178 from a physician practice, and about $151 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 5 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$178$151 to $224
FacilityA hospital or hospital-owned outpatient department$151$135 to $214

How much rates vary

Facilitymedian $151 · 10th to 90th $120 to $214Professionalmedian $178 · 10th to 90th $129 to $302
$100$200$500$1Kfacility $151professional $178

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
$125.89
Median
$177.83
Typical High
$213.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$177.83
Typical High
$302.00
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$165.96
Median
$229.09
Typical High
$416.87
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$218.78
Typical High
$331.13
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$186.21
Median
$229.09
Typical High
$331.13
BCBS
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$229.09
Typical High
$407.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$134.90
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$208.93
Typical High
$407.38
United
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$147.91
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$177.83
Typical High
$309.03
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$85.11
Median
$91.20
Typical High
$295.12

Where Alabama sits

The same service costs 1.7 times more in Minnesota than in Delaware. 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.

Alabama· 48th of 51

$178

MN $295DE $174

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.