New patient office visit (about 60 minutes) in Somerset, PA costs $237 to $800. Here's every hospital's price.
2 hospitals in the Somerset, PA metro area publish a cash price for new patient office visit (about 60 minutes) (CPT 99205). We read their files every month so you don't have to.
Across the Somerset, PA metro area, 2 hospitals list a cash price for new patient office visit (about 60 minutes) (CPT 99205). The lowest is $237 at Chan Soon- Shiong Medical Center at Windber, the median is $237 and the highest is $800 at UPMC Somerset. The most expensive hospital lists 3.4 times the cheapest for the same code.
The Somerset, PA median of $237 is 12% below the national median of $269 across 1126 US hospitals with a cash price for this code.
2 of these hospitals also publish the rates they negotiated with insurers, from $29 to $1,000. With insurance you pay a share of the negotiated rate, which is sometimes higher than the cash price; you may ask for the cash price instead.
The files behind these prices are dated between February 2026 and March 2026. 1 other hospitals in the metro area have no readable price for this code: some publish no file, some block automated reading, some leave the code out. They are listed below so you can call them.
Sorted by cash price
Hospital facility fee onlyWindber · 21 mi · File Feb 2026
Somerset · 3 mi · File Mar 2026
What's in the price
The hospital facility fee for CPT 99205. The doctor, anesthesia and lab work usually bill separately.
Cash vs. insured
Cash is what you pay without insurance. With insurance you pay a share of the negotiated rate, which can be higher than cash. You may ask for the cash price.
What to say on the phone
"I'd like the self-pay price for CPT 99205, in writing, and whether it covers facility, physician and anesthesia."
About new patient office visit (about 60 minutes)
CPT 99205 is the highest new-patient office visit level: about an hour, high complexity, typically a serious or complicated diagnosis, multiple chronic conditions, or decisions about major treatment. It is common in oncology, cardiology and neurology first visits.
What the price covers
When a hospital lists it, this is the price at a hospital-owned clinic or outpatient department, often with a facility fee on top of the clinician's fee. Any tests, imaging or procedures ordered are separate.
Why prices vary
Prices for the same visit level differ mainly by ownership: hospital-owned practices add facility fees; independent practices do not. Academic medical centers list the highest charges. Cash prices are usually far below the gross charge.
Questions to ask
- What is the self-pay price for 99205 including any facility fee?
- Could the visit be booked at an independent practice with the same specialist?
- What is included, and what will be billed separately?
Hospitals in Somerset, PA without a price for this procedure
Listed so you know who to call. The reason is what we found on their website.
- Conemaugh Meyersdale Medical Centercode not in file