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South Dakota rates for HCPCS 99205

Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high 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 $200 · 10th–90th $135–$4070%10%20%10th90th$200Professionalmedian $245 · 10th–90th $145–$5250%5%10%10th90th$245$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
$134.90 / $173.78 / $407.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $223.87 / $524.81
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$173.78 / $302.00 / $537.03
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $281.84 / $295.12
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $281.84 / $363.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $323.59 / $489.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $218.78 / $389.05
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $338.84 / $1,380.38
Medica
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$338.84 / $363.08 / $562.34
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $346.74 / $426.58
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $316.23 / $457.09
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $302.00 / $426.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $275.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $245.47 / $436.52
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$91.20 / $91.20 / $295.12
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $281.84 / $346.74