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Office Visit, New Patient (High Complexity)

Nevada 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?

$224

Typical negotiated rate. In Nevada, July 2026.

Insurers have agreed to pay about $224 for this service. The price depends on where it is billed: about $224 from a physician practice, and about $204 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$224$170 to $339
FacilityA hospital or hospital-owned outpatient department$204$166 to $214

How much rates vary

Facilitymedian $204 · 10th to 90th $129 to $234Professionalmedian $224 · 10th to 90th $141 to $589
$100$200$500$1Kfacility $204professional $224

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$186.21
Typical High
$218.78
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$416.87
Median
$416.87
Typical High
$416.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$223.87
Typical High
$616.60
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$144.54
Median
$257.04
Typical High
$724.44
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$234.42
Typical High
$354.81
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$186.21
Median
$234.42
Typical High
$338.84
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$213.80
Typical High
$380.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$134.90
Typical High
$288.40
Cigna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$218.78
Typical High
$346.74
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$204.17
Typical High
$316.23
Hometown Health
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$870.96
Median
$870.96
Typical High
$870.96
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$354.81
Select Health
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$213.80
Typical High
$234.42
Select Health
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$158.49
Typical High
$295.12
United
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$169.82
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$204.17
Typical High
$354.81
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$85.11
Median
$91.20
Typical High
$426.58

Where Nevada 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.

Nevada· 19th of 51

$224

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.