Office visits · procedure code 99204

Longer new patient visit cost in Murray, KY

What health plans have contracted to pay providers for Office visit, new patient, 45 to 59 minutes in the Murray market, from the machine-readable files those plans publish under federal law. Not billed charges, and not an estimate.

Metro market

Longer new patient visit

Murray, KY · procedure code 99204

Local · metro· n=259Pooled filings, payers not identified
Medicare
$113
25th
$132
Median
$149
75th
$165
90th
$11325th
$132Median
$14975th
$16590th
$168Medicare

Middle price

$132

Half of this market is above it, half below

Middle half spans

$113 to $149

1.3x from low to high

The expensive end

$165

What the priciest providers charge

Medicare reference · Kentucky (nearest published locality)

$168

Performed in an office

$114

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. For your city, not a statewide average. 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 $113 to $149, a 1.3x difference for the same procedure code in the same city. That gap is between contracts, not between quality.

Against Medicare

The middle price sits at 79% of what Medicare pays for the same service at its Kentucky locality. Medicare is a fixed reference line most finance teams already have a feel for, which is why we print it beside every figure. It is not a fair price and not what anything should cost.

The expensive end

One in ten filings sits at or above $165. 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, though this is a smaller market and we mark it as one. 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.

Of the 6 markets compared here, Murray, KY has the 2nd highest middle price.

Local · metro
MarketLow endMiddleHigh endProvidersBasis
Murray, KY this page$113$132$149259Local · metro
Louisville/Jefferson County, KY$91$122$1757,225Local · metro
Lexington, KY$94$123$1853,704Local · metro
Pikeville, KY$96$122$155760Local · metro
Bowling Green, KY$99$137$2091,320Local · metro
Corbin, KY$94$122$148693Local · 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.

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