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Iowa rates for HCPCS 99213

Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.

Facilitymedian $102 · 10th–90th $55–$3550%10%10th90th$102Professionalmedian $87 · 10th–90th $50–$2140%10%10th90th$87$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
$54.95 / $120.23 / $346.74
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$69.18 / $234.42 / $354.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $87.10 / $208.93
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$50.12 / $89.13 / $213.80
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$38.02 / $131.83 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $97.72 / $208.93
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $107.15 / $173.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $77.62 / $134.90
Medica
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$151.36 / $186.21 / $186.21
Medica
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$23.99 / $29.51 / $29.51
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $134.90 / $416.87
Medica
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$100.00 / $151.36 / $213.80
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $134.90 / $177.83
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $144.54 / $204.17
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $91.20 / $446.68
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $107.15 / $199.53
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $63.10 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $89.13 / $177.83
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $81.28 / $138.04
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $102.33 / $128.82