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Office Visit, New Patient (High Complexity)

Iowa rates for HCPCS 99205

An initial, in-depth appointment with a doctor or provider the patient has not seen before, involving a high level of medical decision-making, such as managing multiple serious conditions or health issues that carry significant risk. It's the most involved level of a first-time office visit and typically takes considerably more time than a routine new-patient appointment. It reflects the most complex end of new-patient evaluations.

Rates data updated July 2026.

How much does Office Visit, New Patient (High Complexity) cost?

$240

Typical negotiated rate. In Iowa, July 2026.

Insurers have agreed to pay about $240 for this service. The price depends on where it is billed: about $240 from a physician practice, and about $251 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$240$174 to $380
FacilityA hospital or hospital-owned outpatient department$251$186 to $339

How much rates vary

Facilitymedian $251 · 10th to 90th $148 to $417Professionalmedian $240 · 10th to 90th $138 to $631
$50$100$200$500$1Kfacility $251professional $240

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$302.00
Typical High
$446.68
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$234.42
Typical High
$660.69
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$165.96
Median
$309.03
Typical High
$691.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$295.12
Typical High
$512.86
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$295.12
Typical High
$512.86
Medica
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$208.93
Typical High
$389.05
Medica
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$323.59
Typical High
$1,380.38
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$323.59
Median
$588.84
Typical High
$660.69
Midlands
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$363.08
Typical High
$537.03
Midlands
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$371.54
Typical High
$549.54
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$302.00
Typical High
$501.19
United
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$208.93
Typical High
$302.00
United
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$257.04
Typical High
$501.19
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$85.11
Median
$91.20
Typical High
$478.63
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$239.88
Typical High
$323.59

Where Iowa sits

The same service costs 1.7 times more in Minnesota than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Iowa· 11th of 51

$240

MN $295DE $174

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.