Doctor visits and therapy CPT 99204 Outpatient

New patient visit, 45 min cost in St. Louis, MO

In St. Louis, MO-IL, 16 hospitals list a cash price for new patient office visit, about 45 minutes: from $65.80 to $567.36, with a median of $245.70. The lowest listed price is at Carlinville Area Hospital — $179.90 less than the median here. Across Missouri, the median is $213.85 at 48 hospitals.

  • The median here, $245.70, is 5% above the US median of $233.40.
  • That is 1.8× Medicare's 2026 national rate for the same service ($136.02).
  • St. Louis, MO has the lowest median of 2 metro areas in Missouri with at least 10 hospitals pricing this code.
  • 2 of 16 hospitals list a cash price equal to their full list price, with no self-pay discount.

Cash prices at 16 facilities across 14 cities for code 99204, as an outpatient — the setting a self-pay patient normally buys. Collected Sep 27, 2026; the hospital files themselves were last updated between Feb 6, 2026 and Jun 10, 2026.

Lowest$65.80Carlinville Area Hospital
Median$245.70half of hospitals charge less
Highest$567.36in this market
Difference8.6×highest vs lowest

Where each hospital's price falls

Each dot is one hospital's cash price on a scale from the lowest to the highest in St. Louis, MO-IL.

median
Lowest $65.80Highest $567.36

Hospitals, cheapest first

HospitalCash priceList priceInsurers payOff list
Carlinville Area Hospital lowest Carlinville, IL · (217) 854-3141 NEW PT VISIT 4 MODERATE MDM -TC File of Mar 21, 2026 · source file $65.80 $94.00 $33.84–$134.29 30%
St Josephs Hospital Hospital Sisters Third Order of St Francis Breese, IL · (618) 526-4511 HC CLINIC VISIT COMPLEX NEW File of Mar 24, 2026 · source file $151.92 $211.00 $59.08–$211.00 28%
Community Hospital of Staunton Staunton, IL · (618) 635-2200 NEW PT LVL 4 COMP MOD File of Feb 9, 2026 · source file $158.35 $316.70 $91.56–$288.20 50%
Gateway Regional Medical Center Granite City, IL · (618) 798-3000 URGENT CARE LVL 4 NP File of Mar 30, 2026 · source file $173.81 $289.69 $289.69 40%
Mercy Hospital Lincoln Troy, MO · (636) 528-8551 OP Visit Level IV New Pt File of Jun 10, 2026 · source file $191.10 $294.00 $19.11–$294.00 35%
Mercy Hospital Washington Washington, MO · (636) 239-8000 OP Uc Visit Level IV New Pt File of Jun 10, 2026 · source file $230.75 $355.00 $112.05–$3,059.39 35%
Touchette Regional Hospital Cahokia Heights, IL · (618) 332-3060 Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or excee File of Apr 13, 2026 · source file $234.36 $378.00 $162.00–$360.00 38%
Mercy Hospital Lincoln Troy, MO · (636) 528-8551 OP Uc Visit Level IV New Pt File of Jun 10, 2026 · source file $236.60 $364.00 $258.00–$363.00 35%
Mercy Hospital South Saint Louis, MO · (314) 525-1000 OP Uc Visit Level IV New Pt File of Jun 10, 2026 · source file $245.05 $377.00 $276.00–$288.00 35%
Mercy Hospital St Louis Saint Louis, MO · (314) 251-6000 OP Uc Visit Level IV New Pt+1 more line at this price File of Jun 4, 2026 · source file $246.35 $379.00 $24.64–$379.00 35%
Anderson Hospital Maryville, IL · (618) 288-5711 NEW PT LVL 4 COMP MOD File of Feb 6, 2026 · source file $254.65 $509.30 $163.82–$509.31 50%
Mercy Hospital Jefferson Festus, MO · (636) 933-1000 OP Visit Level IV New Pt/Behavioral Health+1 more line at this price File of Jun 10, 2026 · source file $258.05 $397.00 $114.23–$261.99 35%
Mercy Hospital South Saint Louis, MO · (314) 525-1000 OP Visit Level IV New Pt File of Jun 10, 2026 · source file $258.05 $397.00 $25.81–$397.00 35%
Mercy Hospital Washington Washington, MO · (636) 239-8000 OP Visit Level IV New Pt+1 more line at this price File of Jun 10, 2026 · source file $288.60 $444.00 $28.86–$399.60 35%
Jersey Community Hospital Jerseyville, IL · (618) 498-6402 99244 Office Consultation, Level 4 File of Mar 10, 2026 · source file $296.00 $296.00 $60.00–$236.80 —
Mercy Hospital St Louis Saint Louis, MO · (314) 251-6000 OP Visit Level IV New Pt File of Jun 4, 2026 · source file $297.05 $457.00 $114.23–$261.99 35%
Shriners Childrens - St Louis Saint Louis, MO · (314) 432-3600 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES File of Mar 18, 2026 · source file $373.60 $373.60 $115.69–$234.30 —
St Elizabeths Hospital of the Hospital Sisters of the Third Order of St Francis O'Fallon, IL · (618) 234-2120 HC CLINIC VISIT COMPLEX NEW File of Mar 24, 2026 · source file $398.88 $554.00 $155.12–$554.00 28%
St Josephs Hospital of the Hospital Sisters of the Third Order of St Francis Highland, IL · (618) 651-2600 HC CLINIC VISIT COMPLEX NEW File of Mar 24, 2026 · source file $412.56 $573.00 $114.60–$573.00 28%
Carlinville Area Hospital Carlinville, IL · (217) 854-3141 NEW PT VISIT LEVEL 4 File of Mar 21, 2026 · source file $432.60 $618.00 $222.48–$882.86 30%
Hshs Holy Family Hospital Greenville, IL · (618) 664-1230 OFFICE O/P NEW MOD 45 MIN File of Mar 24, 2026 · source file $567.36 $788.00 $146.00–$788.00 28%
Hospital The hospital that published the price, its city and the line exactly as written in its price file.
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More

Outpatient: lowest $65.80, median $245.70, highest $567.36 — a 8.6× difference within the same market.

As an inpatient, the same code is billed by 5 facilities here, median $173.81. Inpatient and outpatient prices are not comparable and are kept on separate pages: the inpatient charge covers admission, not the same purchase.

Cash or insurance?

At 14 of 16 hospitals that publish insurer rates for this code here, the cash price is below the highest rate a health plan has negotiated, and at 3 it is below every plan's rate. If you have insurance but have not met your deductible, you usually pay your plan's negotiated rate, which falls somewhere in the "Insurers pay" column. Paying cash can cost less, but a cash payment usually does not count toward your deductible. Ask the hospital for both numbers before you book.

What new patient visit, 45 min is, what the price covers and why prices differ: New patient visit, 45 min explained.