How much does an Office visit, new patient cost?

Office visit, new patient (level 4) · CPT 99204 · A level-4 new-patient office visit is a more complex or longer initial appointment.

The typical insurer-negotiated price for an Office visit, new patient (level 4) is about $216, with most between $156 and $334 ($286 cash/self-pay). Based on published rates from 2,587 U.S. hospitals. Hospital list charges run about $450 — roughly 2.1× higher.

Insurer-negotiated
$216
typical · $156$334
Cash / self-pay
$286
typical cash price
Hospital list charge
$450
2.1× the negotiated rate

Source: medians across 2,587hospitals' machine-readable price files (required by federal law since 2021). Figures are estimates and vary by hospital, region, insurer, and plan.

Office visit, new patient (level 4) cost — frequently asked questions

How much does an Office visit, new patient (level 4) cost with insurance?

The typical insurer-negotiated rate for an Office visit, new patient (level 4) is about $216, with most falling between $156 and $334, based on published rates from 2,587 U.S. hospitals. What you actually pay depends on your plan's deductible and coinsurance.

How much does an Office visit, new patient (level 4) cost without insurance?

Cash or self-pay prices for an Office visit, new patient (level 4) run around $286. Uninsured patients are often billed the much higher hospital "list" charge first (about $450), so it's worth asking for the cash or self-pay rate and negotiating.

Why is my hospital Office visit, new patient (level 4) bill so much higher?

Hospital "list" (chargemaster) prices for an Office visit, new patient (level 4) run about $450 — roughly 2.1× the $216 insurers actually pay. The list price is a starting point almost no one pays; the negotiated and cash rates are the realistic benchmark.

Can I negotiate the cost of an Office visit, new patient (level 4)?

Yes. If you were charged well above the typical negotiated rate (about $216), that gap is negotiable. Upfronte audits your bill against real hospital pricing data and can negotiate it down on your behalf — no savings, no fee.

Were you charged more than $216?

Upload your bill and Upfronte will check it against real hospital pricing data and negotiate overcharges. No savings, no fee.

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Office visit, new patient (level 4) cost by location

Median negotiated prices for specific states and metro areas.

Metro areas

States

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