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Hospital Consultation, Lower Complexity

Iowa rates for HCPCS 99252

A specialist's opinion on a hospital patient, requested by the doctor already caring for them. The consultant takes a history, examines the patient, reviews the records, and writes back with advice. This is one of the shorter consultations of its kind, for a problem that is fairly limited in complexity.

Rates data updated July 2026.

How much does Hospital Consultation, Lower Complexity cost?

$123

Typical physician fee. In Iowa, July 2026.

Insurers have agreed to pay about $123 for this service. Most negotiated rates run $72.44 to $178.

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.

How much rates vary

Facilitymedian $123 · 10th to 90th $62 to $170Professionalmedian $123 · 10th to 90th $62 to $269
$100$200facility $123professional $123

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
$61.66
Median
$104.71
Typical High
$169.82
Aetna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$123.03
Typical High
$269.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$87.10
Typical High
$229.09
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$123.03
Typical High
$316.23
Medica
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$123.03
Typical High
$169.82
Medica
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$128.82
Typical High
$524.81
Midlands
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$141.25
Typical High
$229.09
Midlands
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$141.25
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$79.43
Typical High
$125.89
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$102.33
Typical High
$169.82
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$89.13
Typical High
$95.50

Where Iowa sits

The same service costs 2.3 times more in South Dakota than in Washington, DC. 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· 14th of 51

$123

SD $158DC $67.61

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.