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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.

Facilitymedian $295 · 10th–90th $178$4270%10%10th90th$295Professionalmedian $204 · 10th–90th $148$7410%10%10th90th$204$20.0$50.0$100.0$200.0$500.0$1.0K

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
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