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Office Visit, New Patient (High Complexity)

Colorado 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?

$200

Typical negotiated rate. In Colorado, July 2026.

Insurers have agreed to pay about $200 for this service. The price depends on where it is billed: about $200 from a physician practice, and about $219 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 7 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$200$162 to $257
FacilityA hospital or hospital-owned outpatient department$219$174 to $282

How much rates vary

Facilitymedian $219 · 10th to 90th $151 to $363Professionalmedian $200 · 10th to 90th $135 to $479
$100$200$500$1Kfacility $219professional $200

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
$104.71
Median
$173.78
Typical High
$309.03
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$223.87
Median
$223.87
Typical High
$501.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$194.98
Typical High
$489.78
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$141.25
Median
$251.19
Typical High
$660.69
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$245.47
Typical High
$371.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$151.36
Typical High
$239.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$251.19
Typical High
$407.38
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$234.42
Typical High
$363.08
Denver HMP
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$331.13
Typical High
$602.56
Select Health
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$239.88
Select Health
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$213.80
Typical High
$281.84
United
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$223.87
Typical High
$346.74
United
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$239.88
Typical High
$407.38
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$91.20
Typical High
$457.09

Where Colorado 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.

Colorado· 37th of 51

$200

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.