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Federally Qualified Health Center (FQHC) Visit, New Patient

Pennsylvania rates for HCPCS G0466

Federally Qualified Health Center (FQHC) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new patient and a FQHC practitioner during which time one or more FQHC services are rendered and includes a typical bundle of Medicare-covered services that would be furnished per diem to a patient receiving a FQHC visit

Rates data updated July 2026.

How much does Federally Qualified Health Center (FQHC) Visit, New Patient cost?

$123

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $123 for this service. The price depends on where it is billed: about $123 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 4 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$123$102 to $123
FacilityA hospital or hospital-owned outpatient department$123$123 to $123

How much rates vary

Facilitymedian $123 · 10th to 90th $123 to $123Professionalmedian $123 · 10th to 90th $100 to $240
$100$200facility $123professional $123

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
$123.03
Median
$123.03
Typical High
$123.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$123.03
Typical High
$245.47
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$83.18
Typical High
$128.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$123.03
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$123.03
Typical High
$123.03

Where Pennsylvania sits

The same service costs 2.5 times more in Minnesota than in New Hampshire. 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.

Pennsylvania· 37th of 51

$123

MN $245NH $100

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.