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Hospital Outpatient Clinic Visit

Ohio 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 Ohio, 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 $61.66 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 9 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 $91.20
FacilityA hospital or hospital-owned outpatient department$61.66$41.69 to $123

How much rates vary

Facilitymedian $62 · 10th to 90th $10 to $182Professionalmedian $87 · 10th to 90th $74 to $107
$0.1$1$10$100$1Kfacility $62professional $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
$9.55
Median
$61.66
Typical High
$165.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$87.10
Typical High
$107.15
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$66.07
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.02
Median
$0.03
Typical High
$93.33
CareSource
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$181.97
Typical High
$199.53
CareSource
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$181.97
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
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$138.04
Typical High
$194.98
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$97.72
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$50.12
Typical High
$60.26
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$70.79
Typical High
$112.20
United
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$363.08
Typical High
$380.19
United
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$79.43
Typical High
$79.43

Where Ohio 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.

Ohio· 27th 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.