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Office visit, new patient, 45-59 min

CPT 99204 · negotiated-rate distribution across hospitals in VA

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Hospitals
8
Min
$285.75
Median
$288.90
Max
$288.90
Range multiplier
1.0×

By payer (19 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare525$134.90$257.27$367.832.7×
Aetna515$229.05$233.10$298.801.3×
Cigna510$285.75$303.98$324.001.1×
sentara health plan510$131.22$205.11$279.002.1×
gateway - tier 155$427.50$427.50$427.501.0×
gateway - tier 255$360.00$360.00$360.001.0×
gateway - tier 355$247.50$247.50$247.501.0×
Humana55$134.90$134.90$134.901.0×
vhn - ultra55$279.00$279.00$279.001.0×
Anthem BCBS55$128.77$128.77$128.771.0×
connecticare55$315.00$315.00$315.001.0×
First Health55$134.90$134.90$134.901.0×
vhn - link55$405.00$405.00$405.001.0×
vhn - plus55$346.50$346.50$346.501.0×
vhn - secondary payors55$427.50$427.50$427.501.0×
vhn55$360.00$360.00$360.001.0×
national provider network11$432.00$432.00$432.001.0×
integrated health plan11$382.50$382.50$382.501.0×
corvel11$116.51$116.51$116.511.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Carilion Stonewall Jackson HospitalLexingtonVA16$450.00$157.50$128.77$288.90$427.50
Carilion Medical CenterRoanokeVA16$450.00$157.50$128.77$288.90$427.50
Carilion New River Valley Med CenterChristiansburgVA16$450.00$157.50$128.77$288.90$427.50
Carilion Franklin Memorial HospitalRocky MountVA16$450.00$157.50$128.77$288.90$427.50
Carilion Tazewell Community HospitalTazewellVA19$450.00$157.50$116.51$285.75$432.00
Childrens Hospital Of The Kings DaNorfolkVA0$745.00$670.50
Lynn House Of Potomac Valley Inc.AlexandriaVA0$455.00$227.50
Bon Secours Depaul Medical CenterNorfolkVA0$654.00$425.10

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.