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Office Visit, New Patient (High Complexity)

Nebraska 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 Nebraska, July 2026.

Insurers have agreed to pay about $209 for this service. The price depends on where it is billed: about $204 from a physician practice, and about $302 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 8 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$204$162 to $347
FacilityA hospital or hospital-owned outpatient department$302$195 to $417

How much rates vary

Facilitymedian $302 · 10th to 90th $141 to $457Professionalmedian $204 · 10th to 90th $135 to $447
$100$200$500$1Kfacility $302professional $204

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
$120.23
Median
$363.08
Typical High
$630.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$199.53
Typical High
$446.68
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$162.18
Median
$346.74
Typical High
$467.74
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$251.19
Typical High
$426.58
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$186.21
Median
$275.42
Typical High
$446.68
BCBS
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$416.87
BCBS
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$295.12
Typical High
$407.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$218.78
Typical High
$288.40
Cigna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$316.23
Typical High
$524.81
Medica
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$239.88
Typical High
$380.19
Medica
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$389.05
Typical High
$1,122.02
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$309.03
Median
$398.11
Typical High
$524.81
Midlands
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$354.81
Typical High
$426.58
Midlands
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$354.81
Typical High
$489.78
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$234.42
Typical High
$398.11
United
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$177.83
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$257.04
Typical High
$489.78
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$91.20
Median
$91.20
Typical High
$269.15

Where Nebraska 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.

Nebraska· 27th 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.