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Iowa rates for HCPCS 99212

Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 10 minutes must be met or exceeded.

Facilitymedian $65 · 10th–90th $30–$1780%10%10th90th$65Professionalmedian $58 · 10th–90th $30–$1380%5%10%10th90th$58$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
$29.51 / $77.62 / $158.49
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$25.12 / $204.17 / $524.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $54.95 / $134.90
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$32.36 / $61.66 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $56.23 / $123.03
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $67.61 / $107.15
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27.54 / $48.98 / $83.18
Medica
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$93.33 / $100.00 / $100.00
Medica
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$15.14 / $15.85 / $15.85
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $72.44 / $354.81
Medica
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$63.10 / $95.50 / $131.83
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $81.28 / $120.23
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $83.18 / $123.03
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $75.86 / $288.40
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $61.66 / $123.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.39 / $35.48 / $69.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $54.95 / $107.15
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $85.11 / $85.11
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $54.95 / $81.28