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Office Visit, New Patient (High Complexity)

North Dakota 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?

$240

Typical negotiated rate. In North Dakota, July 2026.

Insurers have agreed to pay about $240 for this service. The price depends on where it is billed: about $240 from a physician practice, and about $166 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 4 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$240$182 to $427
FacilityA hospital or hospital-owned outpatient department$166$141 to $204

How much rates vary

Facilitymedian $166 · 10th to 90th $126 to $339Professionalmedian $240 · 10th to 90th $155 to $550
$200$500$1Kfacility $166professional $240

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
$154.88
Typical High
$204.17
Aetna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$239.88
Typical High
$549.54
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$169.82
Median
$338.84
Typical High
$588.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$338.84
Typical High
$549.54
Medica
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$229.09
Typical High
$398.11
Medica
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$380.19
Typical High
$1,380.38
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$323.59
Median
$457.09
Typical High
$562.34
United
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$281.84
Typical High
$489.78
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$85.11
Typical High
$213.80

Where North Dakota 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.

North Dakota· 10th of 51

$240

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.