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.
Original text from hospital filings
HC VISIT NEW PATIENT LEVEL 4
Low
$1
Average
$189
Median
$141
High
$2.8k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
508 hospitals; the 90th percentile is 4.1× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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753 hospital rates
iThe hospitals that file a Molina rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Seattle Children's Hospital Seattle, WA professional · fee schedule · both | 2 | $169 | $169 | $39 | 23% | 1,279 | $130 – $209 |
| 2 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · outpatientfrom % of charges | 2 | $71 | $71 | $35 | 49% | 1,141 | $36 – $105 |
| 3 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · outpatient | 5 | $168 | $157 | $45 | 29% | 481 | $108 – $231 |
| 4 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 6 | $108 | $106 | $9 | 8% | 456–474 | $93 – $115 |
| 5 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · outpatient | 5 | $143 | $142 | $30 | 22% | 379 | $113 – $196 |
| 6 | Mount Carmel East Reynoldsburg, OH professional · fee schedule · outpatient | 4 | $132 | $133 | $38 | 28% | 285 | $93 – $175 |
| 7 | Beaufort Memorial Hospital Beaufort, SC professional · percent of total billed charges · bothfrom % of charges | 1 | $114 | $114 | — | — | 172 | $114 – $114 |
| 8 | Saint Alphonsus Regional Medical Center - Boise Boise, ID professional · fee schedule · both | 5 | $163 | $193 | $67 | 35% | 158–167 | $146 – $325 |
| 9 | Saint Alphonsus Medical Center - Nampa Nampa, ID professional · fee schedule · both | 5 | $109 | $130 | $43 | 33% | 117 | $103 – $216 |
| 10 | Appalachian Regional Healthcare, Inc. Hazard, KY percent of total billed charges · outpatientfrom % of charges | 1 | $214 | $214 | — | — | 81 | $214 – $214 |
| 11 | Public Hospital District No 4 King County WA Snoqualmie, WA fee schedule · outpatient | 3 | $88 | $135 | $87 | 64% | 78 | $35 – $312 |
| 12 | Mount Carmel St Ann's Lewis Center, OH professional · percent of total billed charges · outpatientfrom % of charges | 1 | $370 | $370 | — | — | 68 | $370 – $370 |
| 13 | St Mary Mercy Livonia Livonia, MI professional · fee schedule · outpatient | 5 | $176 | $177 | $36 | 21% | 68–86 | $144 – $243 |
| 14 | Parkland Health Dallas, TX facility · percent of total billed charges · bothfrom % of charges | 4 | $240 | $280 | $181 | 65% | 48 | $98 – $551 |
| 15 | Nor-Lea Hospital District Lovington, NM professional · fee schedule · both | 1 | $81 | $81 | — | — | 45 | $81 – $81 |
| 16 | Mercy Medical Center-Clinton Inc Clinton, IA professional · fee schedule · both | 6 | $92 | $93 | $11 | 12% | 36 | $81 – $115 |
| 17 | HOLLAND COMMUNITY HOSPITAL Holland, MI percent of total billed charges · outpatientfrom % of charges | 1 | $60 | $67 | $25 | 37% | 27 | $40 – $101 |
| 18 | Appalachian Regional Healthcare, Inc. Middlesboro, KY percent of total billed charges · outpatientfrom % of charges | 1 | $213 | $213 | — | — | 23 | $213 – $213 |
| 19 | Appalachian Regional Healthcare, Inc. McDowell, KY percent of total billed charges · outpatientfrom % of charges | 1 | $54 | $57 | $22 | 39% | 15 | $32 – $85 |
| 20 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · both | 2 | $113 | $113 | — | — | 15 | $113 – $113 |
| 21 | Mount Carmel Grove City Grove City, OH professional · percent of total billed charges · bothfrom % of charges | 1 | $370 | $370 | — | — | 15–24 | $370 – $370 |
| 22 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · outpatient | 2 | $170 | $170 | $27 | 16% | 14 | $143 – $196 |
| 23 | Stony Brook University Hospital Stony Brook, NY facility · other · outpatient | 1 | $227 | $204 | $29 | 14% | 14–41 | $168 – $227 |
| 24 | Methodist Hospitals of Dallas Dallas, TX percent of total billed charges · bothfrom % of charges | 1 | $227 | $227 | — | — | 12 | $227 – $227 |
| 25 | PRISMA HEALTH BAPTIST EASLEY HOSPITAL EASLEY, SC per diem · both | 1 | $123 | $123 | — | — | 11 | $123 – $123 |
← Payers reporting CPT 99204 · Snapshot 20261111T120946Z-9134e7f7