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Detailed Specialist Consultation

Iowa rates for HCPCS 99244

This office visit covers a thorough consultation with a specialist, called in by another doctor to evaluate a specific problem and give an opinion or recommendation back to the referring provider. It involves a detailed history, a comprehensive examination, and decision-making of moderate complexity. A written report is typically sent back to the doctor who requested the opinion.

Rates data updated July 2026.

How much does Detailed Specialist Consultation cost?

$166

Typical negotiated rate. In Iowa, July 2026.

Insurers have agreed to pay about $166 for this service. The price depends on where it is billed: about $166 from a physician practice, and about $219 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$166$138 to $245
FacilityA hospital or hospital-owned outpatient department$219$155 to $288

How much rates vary

Facilitymedian $219 · 10th to 90th $135 to $347Professionalmedian $166 · 10th to 90th $115 to $603
$100$200$500facility $219professional $166

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
$194.98
Median
$269.15
Typical High
$380.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$162.18
Typical High
$602.56
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$181.97
Typical High
$346.74
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$234.42
Typical High
$660.69
Medica
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$186.21
Typical High
$331.13
Medica
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$275.42
Typical High
$1,122.02
Midlands
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$309.03
Typical High
$537.03
Midlands
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$302.00
Typical High
$501.19
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$776.25
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$162.18
Typical High
$302.00
United
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$177.83
Typical High
$229.09
United
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$239.88
Typical High
$398.11
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$181.97
Typical High
$223.87

Where Iowa sits

The same service costs 1.5 times more in Minnesota than in West Virginia. 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· 16th of 51

$166

MN $219WV $141

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.