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Hospital Outpatient Clinic Visit

Illinois 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 Illinois, 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 $123 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$87.10$81.28 to $93.33
FacilityA hospital or hospital-owned outpatient department$123$85.11 to $166

How much rates vary

Facilitymedian $123 · 10th to 90th $54 to $234Professionalmedian $87 · 10th to 90th $74 to $123
$50$100$200$500$1Kfacility $123professional $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
$53.70
Median
$123.03
Typical High
$223.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$87.10
Typical High
$107.15
BCBS
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$234.42
Typical High
$269.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$97.72
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$218.78
Typical High
$245.47
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$2,511.89
United
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$316.23
Typical High
$354.81
United
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$64.57
Typical High
$85.11

Where Illinois 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.

Illinois· 4th 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.