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Comprehensive Specialist Consultation Visit

Iowa rates for HCPCS 99245

This is an in-depth office visit where a specialist evaluates a patient at the request of another provider, involving a thorough review of the patient's history, a detailed examination, and complex medical decision-making. It represents the most involved level of this type of consultation, typically used for patients with complicated or multiple medical problems. A written report is usually sent back to the referring provider afterward.

Rates data updated July 2026.

How much does Comprehensive Specialist Consultation Visit cost?

$209

Typical negotiated rate. In Iowa, July 2026.

Insurers have agreed to pay about $209 for this service. The price depends on where it is billed: about $204 from a physician practice, and about $295 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$204$174 to $282
FacilityA hospital or hospital-owned outpatient department$295$209 to $372

How much rates vary

Facilitymedian $295 · 10th to 90th $178 to $427Professionalmedian $204 · 10th to 90th $148 to $741
$100$200$500facility $295professional $204

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
$257.04
Median
$363.08
Typical High
$501.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$204.17
Typical High
$741.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$229.09
Typical High
$436.52
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$309.03
Typical High
$933.25
Medica
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$239.88
Typical High
$416.87
Medica
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$338.84
Typical High
$1,348.96
Midlands
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$407.38
Typical High
$707.95
Midlands
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$398.11
Typical High
$575.44
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$223.87
Typical High
$371.54
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$234.42
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$281.84
Typical High
$457.09
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$245.47
Typical High
$288.40

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· 10th of 51

$209

MN $275WV $178

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.