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Iowa rates for HCPCS 99252

Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.

Facilitymedian $123 · 10th–90th $62–$1700%10%10th90th$123Professionalmedian $110 · 10th–90th $58–$2000%5%10th90th$110$10.0$20.0$50.0$100.0$200.0$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
$61.66 / $117.49 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $109.65 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $85.11 / $229.09
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $123.03 / $316.23
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $123.03 / $169.82
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $128.82 / $524.81
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $141.25 / $229.09
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $141.25
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $120.23 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $100.00 / $169.82
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $93.33 / $102.33