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Iowa rates for HCPCS 99254

Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.

Facilitymedian $245 · 10th–90th $120–$3310%10%10th90th$245Professionalmedian $178 · 10th–90th $120–$5500%10%10th90th$178$10.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $223.87 / $331.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $177.83 / $537.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $169.82 / $446.68
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $257.04 / $512.86
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $245.47 / $331.13
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $275.42 / $1,000.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $275.42 / $446.68
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $275.42
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $223.87 / $346.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $208.93 / $380.19
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $181.97 / $199.53