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Office Visit, New Patient (High Complexity)

Hawaii 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?

$234

Typical negotiated rate. In Hawaii, July 2026.

Insurers have agreed to pay about $234 for this service. The price depends on where it is billed: about $234 from a physician practice, and about $447 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$234$178 to $380
FacilityA hospital or hospital-owned outpatient department$447$389 to $501

How much rates vary

Facilitymedian $447 · 10th to 90th $240 to $537Professionalmedian $234 · 10th to 90th $145 to $724
$100$200$500$1Kfacility $447professional $234

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
$275.42
Median
$446.68
Typical High
$537.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$234.42
Typical High
$724.44
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$151.36
Median
$263.03
Typical High
$776.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$234.42
Typical High
$478.63
HMSA
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$43.65
Typical High
$44.67
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$245.47
Typical High
$346.74
United
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$141.25
United
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$213.80
Typical High
$316.23
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$85.11
Typical High
$457.09
University Health Alliance
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$263.03
Typical High
$446.68

Where Hawaii 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.

Hawaii· 13th of 51

$234

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.