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Iowa rates for HCPCS 99245

Office or other outpatient consultation for a new or established 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, 55 minutes must be met or exceeded.

Facilitymedian $316 · 10th–90th $182–$4270%20%10th90th$316Professionalmedian $204 · 10th–90th $141–$6920%20%10th90th$204$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
$295.12 / $371.54 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $199.53 / $691.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $223.87 / $416.87
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $309.03 / $933.25
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $239.88 / $416.87
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $338.84 / $1,348.96
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $398.11 / $707.95
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $398.11 / $575.44
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $234.42 / $457.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $239.88 / $281.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $257.04 / $446.68
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $251.19 / $295.12