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Hospital Outpatient Clinic Visit

Idaho rates for HCPCS G0463

Hospital outpatient clinic visit for assessment and management of a patient

Rates data updated July 2026.

How much does Hospital Outpatient Clinic Visit cost?

$87.10

Typical negotiated rate. In Idaho, July 2026.

Insurers have agreed to pay about $87.10 for this service. The price depends on where it is billed: about $87.10 from a physician practice, and about $93.33 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$87.10$74.13 to $87.10
FacilityA hospital or hospital-owned outpatient department$93.33$74.13 to $117

How much rates vary

Facilitymedian $93 · 10th to 90th $55 to $257Professionalmedian $87 · 10th to 90th $74 to $107
$10$20$50$100$200$500$1Kfacility $93professional $87

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
$13.49
Median
$95.50
Typical High
$363.08
Aetna
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$87.10
Typical High
$107.15
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3.98
Median
$47.86
Typical High
$173.78
BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.98
Median
$3.98
Typical High
$4.37
Cigna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$97.72
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$87.10
Typical High
$154.88
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$2,754.23
Select Health
Setting
Professional
Modifier
Global
Typical Low
$4,265.80
Median
$5,011.87
Typical High
$5,128.61
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$79.43

Where Idaho sits

The same service costs 9.1 times more in North Carolina than in Minnesota. 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.

Idaho· 29th of 51

$87.10

NC $166MN $18.20

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.