Office visit (new patient) Cost by Hospital

Office visit (new patient) is a clinic or emergency-department visit. Prices are from 1959 US hospitals across 52 states, from their machine-readable files.

$251median cash price · 1959 hospitals, 52 statestypically $99–$658 depending on the hospital
≈ 1.4× Medicare · Reasonable vs MedicareFind hospitals near you

Price comparison (median)

Chargemaster (list price)
$400
Cash / self-pay
$251
Insurer-negotiated
$187
Medicare pays
$177
$99$658
Median cash $251  ·  Medicare $177  ·  bar = typical cash range (10th–90th percentile)
Is this a fair price?
1× Medicarefair ≈2×5×+

Typical cash price here is $251 — about 1.4× the Medicare rate ($177). Reasonable. A fair cash price is usually within ~2× Medicare ($355).

💡 Asking for the cash price instead of the $400 list price could save about $149 (37%).

Estimate what you’ll pay
Quick fill:

Rough estimate from this procedure’s median insurer-negotiated rate. Your actual cost depends on your plan — confirm with your insurer.

Lowest cash prices

HospitalLocationCashInsurerCMS ratingER waitReadmit
Ochsner Medical Center Acute New Orleans, LA $39 $141 ★ 4/5 174 min —
Arkansas Children's Hospital Little Rock, AR $39 $67 — — —
Arkansas Children's Northwest, Inc Springdale, AR $39 $67 — — —
Amery Hospital & Clinic Amery, WI $39 $176 ★ 2/5 120 min —
Montgomery General Hospital Montgomery, WV $41 $175 — 100 min —
Northwest Missississippi Regional Medical Center Clarksdale, MS $42 $116 ★ 3/5 172 min —
Delta Health System-the Medical Center Greenville, MS $42 $116 ★ 1/5 270 min —
Highland Hills Medical Center Senatobia, MS $42 $116 — 125 min —
East Jefferson General Hospital Metairie, LA $45 $57 ★ 2/5 157 min —
Mercy Hospital, Inc Moundridge, KS $46 $51 — — —
St Mary's Regional Medical Center Lewiston, ME $48 — ★ 4/5 135 min —
Ochsner Medical Center-Hancock Bay Saint Louis, MS $49 $86 ★ 3/5 147 min —
Adventist Health Tulare Tulare, CA $50 $122 ★ 3/5 198 min —
Hancock County Hospital Sneedville, TN $50 $149 — 104 min —
Dickenson Community Hospital Clintwood, VA $50 $84 — 109 min —
Lee County Community Hospital Pennington Gap, VA $50 $77 — 109 min —
Johnson Memorial Hospital Franklin, IN $51 $158 ★ 5/5 139 min —
Wellmont Bristol Regional Medical Center Bristol, TN $51 $124 ★ 2/5 196 min —
Wellmont Holston Valley Medical Center Kingsport, TN $51 $124 ★ 2/5 204 min —
Sycamore Shoals Hospital Elizabethton, TN $51 $158 ★ 2/5 142 min —
Hawkins County Memorial Hospital Rogersville, TN $51 $138 — 113 min —
Greeneville Community Hospital Greeneville, TN $51 $145 ★ 2/5 154 min —
Johnson City Medical Center Johnson City, TN $51 $158 ★ 1/5 211 min —
Indian Path Community Hospital Kingsport, TN $51 $158 — 136 min —
Franklin Woods Community Hospital Johnson City, TN $51 $162 ★ 3/5 178 min —

CMS rating = overall hospital star rating (1–5); ER wait = median minutes in the emergency department; Readmit = 30-day readmission rate (lower is better) — all from Medicare’s Care Compare; “—” = not reported. Data last updated October 2026. Prices from hospitals’ machine-readable files (45 CFR §180); Medicare benchmark from CMS PFS/CLFS/IPPS. Prices below 15% of the median are excluded as likely partial or mis-coded charges. Estimates — confirm with the hospital. Report an incorrect price.

What insurers pay for Office visit (new patient)

Median in-network negotiated rate by insurer, across hospitals that publish it (cheapest first). Your actual rate depends on your specific plan and deductible. Cash / self-pay for comparison: $251; Medicare pays $177.

InsurerHospitalsNegotiated median
Medicaid 272
$111
$57 – $285
AmeriHealth 196
$123
$55 – $379
Centene / Ambetter 529
$128
$43 – $304
Geisinger 62
$131
$79 – $317
Univera 15
$131
$72 – $218
Devoted Health 64
$132
$82 – $236
Molina Healthcare 386
$133
$60 – $296
Medicare 342
$133
$70 – $236
Highmark 120
$133
$66 – $264
UPMC Health Plan 82
$135
$66 – $343
Amerigroup 82
$152
$28 – $395
Tricare / VA 265
$158
$79 – $429
Humana 724
$159
$67 – $411
Independent Health 35
$160
$99 – $253
Anthem 430
$162
$72 – $461
UnitedHealthcare 1172
$165
$66 – $480
UCare 61
$174
$78 – $388
Priority Health 47
$174
$91 – $448
Security Health Plan 53
$175
$75 – $493
Blue Cross Blue Shield 1004
$176
$72 – $511
Sanford Health Plan 69
$179
$77 – $398
AvMed 36
$182
$88 – $541
Aetna 1103
$187
$75 – $552
Kaiser Permanente 163
$193
$71 – $492
HealthPartners 213
$199
$79 – $632
Oscar Health 152
$203
$96 – $645
MVP Health Care 77
$208
$113 – $571
Cigna 852
$223
$83 – $654
Bright Health 26
$223
$43 – $559
EmblemHealth 65
$225
$116 – $648
Medica 180
$239
$85 – $537
Workers' Comp / No-Fault 118
$244
$115 – $864
SelectHealth 34
$252
$117 – $562
Health Net 248
$260
$85 – $833
Healthcare Highways 33
$264
$59 – $494
Coventry 119
$285
$104 – $695
Harvard Pilgrim 40
$292
$124 – $570
MultiPlan / PHCS network 704
$328
$128 – $963

Negotiated rates are from hospitals’ machine-readable files (45 CFR §180); payer names are normalized to major brands, so a brand may span several plans. Estimates — confirm with your insurer.

Where it’s cheapest

StateMedian cash
Mississippi$80
Tennessee$88
West Virginia$139
Louisiana$141
Arkansas$149
New Jersey$155

Prices by city

Chicago, ILPhiladelphia, PAHouston, TXBaltimore, MDDallas, TXAustin, TXNew York, NYBronx, NYNashville, TNBaton Rouge, LABoston, MABrooklyn, NYFort Worth, TXKansas City, MOMiami, FLMilwaukee, WIOmaha, NERochester, NYArlington, TXAurora, COCharlotte, NCCleveland, OHColorado Springs, CODenver, CO

Prices by state

TexasCaliforniaNew YorkPennsylvaniaIllinoisWisconsinFloridaOhioMichiganMinnesotaGeorgiaTennesseeIowaColoradoNorth CarolinaNebraskaLouisianaMissouriIndianaKansasArkansasNew JerseyKentuckyVirginiaMassachusettsArizonaMarylandWashingtonOklahomaMississippiSouth CarolinaWest VirginiaMaineSouth DakotaAlabamaConnecticutOregonNew HampshireUtahMontanaNorth DakotaNevadaIdahoWyomingPuerto RicoNew MexicoVermontDelawareRhode IslandAlaskaHawaiiWashington DC

Does Medicare cover Office visit (new patient)?

Yes — Medicare generally covers Office visit (new patient). It is typically an outpatient service under Medicare Part B, with a Medicare-approved amount of about $177. After your annual Part B deductible, you typically owe the 20% coinsurance — roughly $35 — unless a Medicare Advantage or supplemental (Medigap) plan covers it.

General guidance from Medicare’s national rates — your actual coverage and share depend on medical necessity, your plan, and where the service is performed. Confirm with Medicare or your plan.

About these prices

Based on prices published by 1959 US hospitals across 52 states, the typical (median) cash price is $251, versus a chargemaster (list) price around $400, a median insurer-negotiated rate of $187, a Medicare rate of about $177. Most cash prices fall between $99 and $658 — a wide spread, which is exactly why comparing hospitals pays off.

How to save

  • Ask each hospital for its cash / self-pay price — for shoppable services it is often far below the list price.
  • Compare several nearby hospitals; prices for the same service can differ severalfold.
  • Request a written estimate and the billing code (CPT/DRG) before scheduling.
  • Use the Medicare benchmark above to judge whether a quote is reasonable.
  • If you are uninsured, ask about financial assistance or prompt-pay discounts.

Frequently asked questions

How much does Office visit (new patient) cost without insurance?
The median cash (self-pay) price across 1959 US hospitals is $251. Most hospitals fall between $99 and $658. Prices vary widely between hospitals, so it pays to compare before you book.
Does Medicare cover Office visit (new patient)?
Yes — it is generally covered under Medicare Part B as an outpatient service (Medicare-approved amount about $177). After your Part B deductible you typically owe 20% coinsurance, unless a Medicare Advantage or Medigap plan covers it.
What does Medicare pay for Office visit (new patient)?
Medicare pays about $177. We show this as a benchmark — a fair cash price is often within a few multiples of the Medicare rate.
Why do Office visit (new patient) prices vary between hospitals?
Hospitals set their own chargemaster and cash prices and negotiate different rates with each insurer, so two hospitals in the same area can charge very differently for the same service.
Is the cash price lower than using insurance?
Sometimes. If you are uninsured or have a high deductible, the cash/self-pay price can be lower than the insurer-negotiated rate — ask the hospital for both.

Related Office & ER Visits

Emergency department visit (level 3)Emergency department visit (level 4)Emergency department visit (level 2)Emergency department visit (level 1)Emergency department visitEmergency department visit (level 5)Office visit (established patient)Office visit, established patient (level 3)

See more Office & ER Visits.