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FQHC Visit, Established Patient

Massachusetts rates for HCPCS G0467

Federally Qualified Health Center (FQHC) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established 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 FQHC Visit, Established Patient cost?

$95.50

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $95.50 for this service. The price depends on where it is billed: about $95.50 from a physician practice, and about $75.86 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$95.50$69.18 to $95.50
FacilityA hospital or hospital-owned outpatient department$75.86$69.18 to $97.72

How much rates vary

Facilitymedian $76 · 10th to 90th $69 to $174Professionalmedian $95 · 10th to 90th $69 to $135
$100$200$500facility $76professional $95

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
$69.18
Median
$69.18
Typical High
$69.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$95.50
Typical High
$173.78
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
BCBS
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$173.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$79.43
Typical High
$177.83
Health New England
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Tufts
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$151.36
Typical High
$489.78
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$79.43

Where Massachusetts sits

The same service costs 2.2 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.

Massachusetts· 25th of 51

$95.50

MN $182NH $83.18

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.