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Hospital Outpatient Clinic Visit

New York 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 New York, 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 $87.10 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$74.13 to $87.10
FacilityA hospital or hospital-owned outpatient department$87.10$66.07 to $229

How much rates vary

Facilitymedian $87 · 10th to 90th $44 to $479Professionalmedian $87 · 10th to 90th $74 to $98
$0.1$1$10$100$1Kfacility $87professional $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
$47.86
Median
$87.10
Typical High
$478.63
Aetna
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$87.10
Typical High
$93.33
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.02
Median
$0.03
Typical High
$93.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Cigna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$97.72
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$0.10
Median
$0.10
Typical High
$0.10
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$67.61
Typical High
$165.96
United
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$371.54
Typical High
$398.11
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$199.53
Typical High
$234.42

Where New York 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.

New York· 11th 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.