Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
Colorado Pricing in Context
In Colorado, CPT code 99204 (New Patient Office Or Other Outpatient Visit, 45-59 Minutes) carries an average Medicare payment of $110.79 — 1% below the national benchmark of $111.40. 10.1K providers across the state submitted claims for this procedure in 2023, performing 174.7K total services. Individual payments in CO ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.
The average billed charge in Colorado is $398.44, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Colorado sits below the national Medicare average, commercial rates in the state may also run lower than the US median.
Using RAND 2024 commercial-to-Medicare ratios for Office Visit procedures, the estimated commercial insurance price in Colorado lands near $364.19, with self-pay cash prices typically around $228.33. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.
Frequently Asked Questions
How much does New Patient Office Or Other Outpatient Visit, 45-59 Minutes cost in Colorado?
The average Medicare payment for New Patient Office Or Other Outpatient Visit, 45-59 Minutes in Colorado is $110.79, which is 1% below the national average of $111.40. Providers in CO typically bill $398.44 for this procedure.
What does New Patient Office Or Other Outpatient Visit, 45-59 Minutes cost with insurance in Colorado?
With commercial insurance in Colorado, New Patient Office Or Other Outpatient Visit, 45-59 Minutes costs an estimated $364.19. Without insurance, the estimated cash price is $228.33. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.
How many providers perform New Patient Office Or Other Outpatient Visit, 45-59 Minutes in Colorado?
10.1K providers in Colorado billed Medicare for New Patient Office Or Other Outpatient Visit, 45-59 Minutes in 2023, performing 174.7K total services. Medicare payments ranged from N/A to N/A depending on the provider.
Is New Patient Office Or Other Outpatient Visit, 45-59 Minutes cheaper in Colorado than the national average?
Yes — New Patient Office Or Other Outpatient Visit, 45-59 Minutes costs 1% below the national average in Colorado. The state average Medicare payment is $110.79 compared to $111.40 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.
Related Guides
Related Data Sources
Data from CMS Medicare Physician & Other Practitioners (2023).
Read our methodology — how this data is sourced, computed, and verified.