Office visits · procedure code 99204

Longer new patient visit cost in Michigan

Midland, MI has 30 filings for Office visit, new patient, 45 to 59 minutes. We need 100 before we will publish a market figure, so this page shows Michigan instead and says so. These are the rates plans published under federal law. Not billed charges, and nothing here is scaled, adjusted or estimated to stand in for the market we do not hold.

State market

Longer new patient visit

MI · procedure code 99204

Statewide· n=7,094Pooled filings, payers not identified

We do not have a publishable distribution for Midland, MI, so this is the MI market instead. The label above says so on purpose.

Medicare
$136
25th
$169
Median
$207
75th
$330
90th
$13625th
$169Median
$20775th
$33090th
$171Medicare

Middle price

$169

Half of this market is above it, half below

Middle half spans

$136 to $207

1.5x from low to high

The expensive end

$330

What the priciest providers charge

Medicare reference · Rest Of Michigan (nearest published locality)

$171

Performed in an office

$116

Physician fee in a facility

Read this carefully. The facility figure is the physician fee only. When the same service happens in a hospital outpatient department, the hospital bills its own facility payment on top, and that amount is not in this dataset. So the lower number here does not mean the hospital is the cheaper site. It usually is not. We will not publish a total cost by site of service until we hold the facility payment.

Negotiated prices from published filings, reported only where the sample supports it. Statewide peer distribution, not a single-city sample. What plans have agreed to pay, not what a patient is billed. Filings as of July 20, 2026.

Reading it

What this distribution actually says.

The spread

The middle half of this market runs from $136 to $207, a 1.5x difference for the same procedure code in the same city. That gap is between contracts, not between quality.

Against Medicare

Medicare pays $171 for this service at its Rest Of Michigan locality. We do not turn that into a percentage here, because the price above is Michigan and that Medicare figure is one locality inside it. Two different maps do not divide.

The expensive end

One in ten filings sits at or above $330. If a plan's network is weighted toward that end, the difference does not show up in a premium quote. It shows up in the claims.

How wide the data runs

The carriers that filed for this procedure in this market. What each plan has agreed to pay, side by side. These are prices, not bills, so they do not show how often anyone needs it.

The same service elsewhere

Longer new patient visit across other markets.

Local · metro5 of 6 measured locally
MarketLow endMiddleHigh endProvidersBasis
Michigan this page$136$169$2077,094Statewide
Detroit, MI$136$169$1853,085Local · metro
Grand Rapids, MI$141$180$213740Local · metro
Ann Arbor, MI$138$174$241837Local · metro
Lansing, MI$129$185$213188Local · metro
Flint, MI$135$180$189168Local · metro

Put this in front of a client.

Every figure on this page carries its source, its scope and the date the corpus was built, so it survives being forwarded to someone who was not in the meeting.

Book a callHow we compute this