Office visits · procedure code 99204
Longer new patient visit cost in Iowa
No plan has filed Office visit, new patient, 45 to 59 minutes in Ottumwa, IA in a form we can read, so this page shows Iowa instead and says so. These are the rates plans published under federal law. Not billed charges, and nothing here is scaled, adjusted or estimated to stand in for the market we do not hold.
State market
Longer new patient visit
IA · procedure code 99204
We do not have a publishable distribution for Ottumwa, IA, so this is the IA market instead. The label above says so on purpose.
Middle price
$185
Half of this market is above it, half below
Middle half spans
$151 to $212
1.4x from low to high
The expensive end
$322
What the priciest providers charge
Medicare reference · Iowa (nearest published locality)
$166
Performed in an office
$110
Physician fee in a facility
Read this carefully. The facility figure is the physician fee only. When the same service happens in a hospital outpatient department, the hospital bills its own facility payment on top, and that amount is not in this dataset. So the lower number here does not mean the hospital is the cheaper site. It usually is not. We will not publish a total cost by site of service until we hold the facility payment.
Negotiated prices from published filings, reported only where the sample supports it. Statewide peer distribution, not a single-city sample. What plans have agreed to pay, not what a patient is billed. Filings as of July 20, 2026.
Reading it
What this distribution actually says.
The spread
The middle half of this market runs from $151 to $212, a 1.4x difference for the same procedure code in the same city. That gap is between contracts, not between quality.
Against Medicare
Medicare pays $166 for this service at its Iowa locality. We do not turn that into a percentage here, because the price above is Iowa and that Medicare figure is one locality inside it. Two different maps do not divide.
The expensive end
One in ten filings sits at or above $322. If a plan's network is weighted toward that end, the difference does not show up in a premium quote. It shows up in the claims.
How wide the data runs
The carriers that filed for this procedure in this market. What each plan has agreed to pay, side by side. These are prices, not bills, so they do not show how often anyone needs it.
The same service elsewhere
Longer new patient visit across other markets.
Put this in front of a client.
Every figure on this page carries its source, its scope and the date the corpus was built, so it survives being forwarded to someone who was not in the meeting.