Outpatient new patient office visit

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HC VISIT NEW PATIENT LEVEL 4

Payers reporting CPT 99204

Payer pricing summary

Low

$116

Average

$1.4k

Median

$249

High

$21.7k

Payer rate distribution

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#
1	Ucare professional · fee schedule · outpatient · +20 other terms	35	$138	$141	$37	26%	1,706–1,751	$88 – $259
2	Cigna fee schedule · outpatient · +34 other terms	176	$204	$234	$331	141%	1,150–1,195	$0 – $4.6k
3	Oscar professional · fee schedule · outpatient · +21 other terms	24	$155	$162	$44	27%	987–1,005	$92 – $259
4	Blue Cross Blue Shield fee schedule · outpatient · +36 other terms	299	$276	$362	$828	229%	695–1,100	$0 – $31.2k
5	UnitedHealthcare fee schedule · outpatient · +43 other terms	305	$164	$1.4k	$26.1k	1856%	497–614	$1 – $1000.0k
6	Aetna fee schedule · outpatient · +39 other terms	257	$156	$327	$1.2k	365%	242–350	$1 – $31.2k
7	Humana fee schedule · outpatient · +34 other terms	227	$160	$263	$521	198%	90–126	$1 – $8.3k
8	Ambetter fee schedule · both · +23 other terms	52	$223	$244	$82	34%	87	$35 – $583
9	Molina fee schedule · outpatient · +28 other terms	88	$124	$136	$63	46%	79–88	$1 – $414
10	Optum professional · fee schedule · outpatient · +23 other terms	46	$143	$131	$37	28%	68–95	$65 – $183
11	Premera professional · fee schedule · outpatient · +14 other terms	22	$184	$182	$28	15%	68–140	$143 – $292
12	Bcbs Mt fee schedule · outpatient · +2 other terms	1	$303	$303	—	—	64	$303 – $303
13	Regence professional · fee schedule · outpatient · +18 other terms	49	$148	$239	$118	50%	10–100	$92 – $518
14	Anthem fee schedule · outpatient · +33 other terms	119	$188	$275	$267	97%	7–70	$34 – $1.8k
15	Tricare fee schedule · both · +24 other terms	43	$132	$160	$93	58%	4–40	$35 – $583
16	First Health fee schedule · outpatient · +21 other terms	38	$443	$587	$553	94%	2–20	$140 – $2.4k
17	Caresource fee schedule · outpatient · +23 other terms	33	$173	$164	$53	32%	2–20	$1 – $389
18	Phcs fee schedule · outpatient · +15 other terms	18	$501	$554	$285	51%	2–20	$127 – $1.3k
19	Bcbs Ar fee schedule · both	1	$116	$116	—	—	2–20	$116 – $116
20	Wellmark fee schedule · both · +25 other terms	36	$189	$185	$29	16%	1–10	$120 – $283
21	Bcbs Mo professional · other · both	1	$178	$178	—	—	1–10	$178 – $178
22	MultiPlan fee schedule · outpatient · +20 other terms	91	$501	$624	$682	109%	—	$25 – $5.4k
23	Kaiser fee schedule · outpatient · +24 other terms	64	$166	$292	$500	171%	—	$59 – $5.0k
24	WellCare fee schedule · both · +26 other terms	57	$128	$136	$23	17%	—	$101 – $178
25	Healthcare Highways percent of total billed charges · outpatientfrom % of charges · +2 other terms	49	$314	$443	$471	106%	—	$29 – $1.7k

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