Office Visit (New, Moderate-High) Cost in Massachusetts
Office o/p new mod 45 min
Massachusetts Average Cost (2026)
+6.4% vs national avgAverage across 2 Medicare localities in Massachusetts
National Average
State Ranking
Cost by Region in Massachusetts
| Region | Office Rate |
|---|---|
| metropolitan boston | $196.04 |
| rest of massachusetts | $181.49 |
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About Office Visit (New, Moderate-High) Costs in Massachusetts
The average Medicare reimbursement for office visit (new, moderate-high) in Massachusetts is $188.77 for an office setting and $120.85 in a hospital. This is about 6% higher than the national average of $177.36.
Medicare patients typically pay 20% of the Medicare rate after meeting their deductible. For this procedure in Massachusetts, that would be roughly $38 for an office visit or $24 in a hospital setting.
Private insurance plans in Massachusetts typically pay between 130% and 200% of Medicare rates for this procedure, putting the total somewhere between $245 and $378.
Without insurance, you may be able to negotiate a cash discount. Many providers in Massachusetts will reduce their fees by 20% to 40% for self-pay patients. Always ask about cash pricing before scheduling your procedure.
Ways to Save on Office Visit (New, Moderate-High)
Compare Insurance Plans
Uninsured? Comparing marketplace plans in Massachusetts could save you thousands on procedures like this.
Compare plans on eHealth →Try Telehealth First
Many consultations can be done virtually for $50-100, saving hundreds vs an in-person visit.
Book on Sesame Care →Save on Prescriptions
If this procedure leads to a prescription, check discount cards for up to 80% savings.
Check prices on GoodRx →Some links are affiliate links. We may earn a commission at no extra cost to you.
More ways to save →Other Procedures in Massachusetts
Office Visit (New, Moderate-High) Cost by State
Office Visit (New, Moderate-High) in Massachusetts: Frequently Asked Questions
How much does office visit (new, moderate-high) cost in Massachusetts?
The average 2026 Medicare rate for office visit (new, moderate-high) (CPT 99204) in Massachusetts is $188.77 in an office setting and $120.85 in a hospital. Private insurance typically pays $245 to $378, and self-pay cash prices often run $151 to $283.
Is office visit (new, moderate-high) cheaper in Massachusetts than the national average?
Massachusetts is about 6% higher than the national average of $177.36. Across all states, Massachusetts ranks #43 of 49 for this procedure. The cheapest state is Arkansas ($161.84) and the most expensive is Alaska ($222.54).
What will I pay out of pocket for office visit (new, moderate-high) in Massachusetts with Medicare?
Medicare patients typically pay 20% of the Medicare rate after meeting their deductible. In Massachusetts that is roughly $38 for an office visit or $24 in a hospital setting.
How can I save on office visit (new, moderate-high) in Massachusetts?
Ask providers for a cash or self-pay price before scheduling; many in Massachusetts reduce fees 20% to 40% for self-pay patients. If you are uninsured, comparing marketplace plans, using telehealth for consultations, and checking prescription discount cards can cut costs further.