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Office Visit, New Patient (High Complexity)

Arizona 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?

$229

Typical negotiated rate. In Arizona, July 2026.

Insurers have agreed to pay about $229 for this service. The price depends on where it is billed: about $229 from a physician practice, and about $214 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$229$170 to $339
FacilityA hospital or hospital-owned outpatient department$214$170 to $339

How much rates vary

Facilitymedian $214 · 10th to 90th $145 to $813Professionalmedian $229 · 10th to 90th $141 to $661
$50$100$200$500$1K$2Kfacility $214professional $229

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
$177.83
Median
$436.52
Typical High
$2,238.72
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$1,584.89
Median
$1,995.26
Typical High
$1,995.26
Aetna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$229.09
Typical High
$660.69
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$154.88
Median
$257.04
Typical High
$707.95
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$218.78
Typical High
$302.00
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$162.18
Median
$223.87
Typical High
$288.40
BCBS
Setting
Facility
Modifier
Global
Typical Low
$29.51
Median
$29.51
Typical High
$29.51
BCBS
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$165.96
Typical High
$263.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$114.82
Typical High
$239.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$208.93
Typical High
$398.11
Medica
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$199.53
Typical High
$338.84
Medica
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$251.19
Typical High
$1,380.38
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$169.82
Median
$263.03
Typical High
$489.78
United
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$128.82
Typical High
$251.19
United
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$199.53
Typical High
$363.08
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$117.49
Typical High
$426.58

Where Arizona 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.

Arizona· 18th of 51

$229

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.