SelfPayRates — hospital cash prices, from the source
Cash prices at 2 facilities across 2 cities for code 99204, as an outpatient — the setting a self-pay patient normally buys. Collected Sep 22, 2026; the hospital files themselves were last updated between Mar 31, 2026 and Mar 31, 2026.
| Hospital | Cash price | List price | Off | File date | |
|---|---|---|---|---|---|
| Holyoke Medical Center
HOLYOKE, MA Office Visit New Level 4 |
$300.00 | $300.00 | — | — file |
|
| Holyoke Medical Center
HOLYOKE, MA Tele Office Visit New Level 4 |
$300.00 | $300.00 | — | — file |
|
| The Mercy Hospital Inc
SPRINGFIELD, MA PR Visit Office Outpatient New Moderate Level |
$330.00 | $330.00 | — | Mar 31, 2026 file |
Outpatient: lowest $300.00, median $300.00, highest $330.00 — a 1.1× difference within the same market.
As an inpatient, the same code is billed by 2 facilities here, median $300.00. Inpatient and outpatient prices are not comparable and are kept on separate pages: the inpatient charge covers admission, not the same purchase.