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Hospital Outpatient Clinic Visit

Iowa rates for HCPCS G0463

Hospital outpatient clinic visit for assessment and management of a patient

Rates data updated July 2026.

How much does Hospital Outpatient Clinic Visit cost?

$87.10

Typical negotiated rate. In Iowa, July 2026.

Insurers have agreed to pay about $87.10 for this service. The price depends on where it is billed: about $87.10 from a physician practice, and about $95.50 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 7 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$87.10$87.10 to $107
FacilityA hospital or hospital-owned outpatient department$95.50$77.62 to $148

How much rates vary

Facilitymedian $95 · 10th to 90th $48 to $363Professionalmedian $87 · 10th to 90th $74 to $145
$10$20$50$100$200$500facility $95professional $87

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
$47.86
Median
$95.50
Typical High
$363.08
Aetna
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$87.10
Typical High
$131.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$158.49
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$181.97
Typical High
$302.00
Medica
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$147.91
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$128.82
Typical High
$234.42
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$199.53
Typical High
$239.88
United
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$70.79
Typical High
$85.11
Wellmark
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$28.84
Typical High
$28.84

Where Iowa sits

The same service costs 9.1 times more in North Carolina than in Minnesota. 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· 25th of 51

$87.10

NC $166MN $18.20

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.