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
$50
Average
$444
Median
$132
High
$10.7k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
211 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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289 hospital rates
iThe hospitals that file a Tricare 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 | Saint Alphonsus Regional Medical Center - Boise Boise, ID professional · fee schedule · both | 1 | $153 | $153 | — | — | 173 | $153 – $153 |
| 2 | Saint Alphonsus Medical Center - Nampa Nampa, ID professional · fee schedule · both | 1 | $121 | $121 | — | — | 66 | $121 – $121 |
| 3 | Massachusetts General Hospital Boston, MA other · both | 1 | $145 | $145 | — | — | 46 | $145 – $145 |
| 4 | Massachusetts General Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $636 | $636 | — | — | 46 | $636 – $636 |
| 5 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 1 | $122 | $122 | — | — | 36 | $122 – $122 |
| 6 | Mayo Clinic Health System Sparta, WI professional · fee schedule · outpatient | 1 | $155 | $155 | — | — | 22–31 | $155 – $155 |
| 7 | Mishawaka Medical Center Mishawaka, IN professional · fee schedule · outpatient | 1 | $154 | $154 | — | — | 13 | $154 – $154 |
| 8 | Mercy Hospital Berryville Berryville, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $83 | $82 | $11 | 13% | 5–50 | $70 – $98 |
| 9 | MVHS, Inc. Utica, NY fee schedule · both | 1 | $150 | $145 | $12 | 8% | 4–40 | $119 – $150 |
| 10 | Mercy Hospital Aurora Aurora, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $95 | $95 | $6 | 6% | 3–30 | $88 – $103 |
| 11 | Mercy St. Francis Hospital View, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $116 | $116 | $4 | 4% | 2–20 | $112 – $120 |
| 12 | Brigham and Women's Hospital Boston, MA other · both | 1 | $145 | $145 | — | — | 1–10 | $145 – $145 |
| 13 | Brigham and Women's Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $636 | $636 | — | — | 1–10 | $636 – $636 |
| 14 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · both | 1 | $130 | $130 | — | — | 1–10 | $130 – $130 |
| 15 | Mount Carmel East Reynoldsburg, OH professional · fee schedule · outpatient | 1 | $157 | $157 | — | — | 1–10 | $157 – $157 |
| 16 | Saint Alphonsus Medical Center - Ontario Ontario, OR professional · fee schedule · both | 1 | $103 | $103 | — | — | 1–10 | $103 – $103 |
| 17 | Saint Francis Hospital and Medical Center Hartford, CT professional · fee schedule · both | 1 | $166 | $166 | — | — | 1–10 | $166 – $166 |
| 18 | Samaritan Hospital Troy, NY professional · fee schedule · both | 1 | $151 | $151 | — | — | 1–10 | $151 – $151 |
| 19 | Springhill Memorial Hospital Mobile, AL other · outpatient | 1 | $101 | $101 | — | — | 1–10 | $101 – $101 |
| 20 | St Peters Hospital Albany, NY professional · fee schedule · outpatient | 1 | $151 | $151 | — | — | 1–10 | $151 – $151 |
| 21 | St. Charles Madras Madras, OR percent of total billed charges · bothfrom % of charges | 1 | $161 | $161 | — | — | 1–10 | $161 – $161 |
| 22 | The Mercy Hospital Inc Springfield, MA professional · fee schedule · both | 1 | $126 | $126 | — | — | 1–10 | $126 – $126 |
| 23 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY professional · fee schedule · outpatient | 4 | $130 | $131 | $18 | 14% | — | $106 – $158 |
| 24 | AnMed Health Anderson, SC professional · fee schedule · inpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 25 | AnMed Health Anderson, SC professional · fee schedule · outpatient | 1 | $143 | $143 | $16 | 11% | — | $127 – $159 |
← Payers reporting CPT 99204 · Snapshot 20261111T120946Z-9134e7f7