go back

Office Visit, New Patient (High Complexity)

Maryland 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?

$209

Typical negotiated rate. In Maryland, July 2026.

Insurers have agreed to pay about $209 for this service. The price depends on where it is billed: about $209 from a physician practice, and about $186 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$209$166 to $302
FacilityA hospital or hospital-owned outpatient department$186$151 to $363

How much rates vary

Facilitymedian $186 · 10th to 90th $123 to $501Professionalmedian $209 · 10th to 90th $138 to $490
$50$100$200$500$1Kfacility $186professional $209

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
$123.03
Median
$204.17
Typical High
$501.19
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$213.80
Typical High
$501.19
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$154.88
Median
$295.12
Typical High
$741.31
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$151.36
Typical High
$223.87
Cigna
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$144.54
Typical High
$186.21
Cigna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$218.78
Typical High
$363.08
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$251.19
Typical High
$354.81
United
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$162.18
Typical High
$199.53
United
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$208.93
Typical High
$371.54
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$89.13
Typical High
$457.09
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$229.09
Typical High
$346.74

Where Maryland 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.

Maryland· 29th of 51

$209

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.