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Iowa rates for HCPCS 99205

Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.

Facilitymedian $245 · 10th–90th $138–$3980%10%10th90th$245Professionalmedian $257 · 10th–90th $145–$6460%10%10th90th$257$1.0$5.0$20.0$100.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $281.84 / $426.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $234.42 / $616.60
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$165.96 / $338.84 / $724.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $281.84 / $501.19
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $295.12 / $512.86
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $208.93 / $389.05
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $323.59 / $1,380.38
Medica
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$323.59 / $588.84 / $660.69
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $354.81 / $489.78
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $407.38 / $549.54
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $302.00 / $501.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $208.93 / $275.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $234.42 / $478.63
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $91.20 / $478.63
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $257.04 / $316.23