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Office Visit, Established Patient (Straightforward)

South Dakota rates for HCPCS 99212

A brief follow-up appointment with a doctor or other provider the patient has seen before, used for simple, low-complexity issues that don't require much evaluation or decision-making. It's the most basic level of an established-patient office visit, often used for minor concerns or quick check-ins. Visit length and content are limited compared to visits addressing more involved problems.

Rates data updated July 2026.

How much does Office Visit, Established Patient (Straightforward) cost?

$54.95

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $54.95 for this service. The price depends on where it is billed: about $53.70 from a physician practice, and about $97.72 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 8 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$53.70$34.67 to $89.13
FacilityA hospital or hospital-owned outpatient department$97.72$85.11 to $135

How much rates vary

Facilitymedian $98 · 10th to 90th $51 to $316Professionalmedian $54 · 10th to 90th $29 to $135
$20$50$100$200facility $98professional $54

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
$77.62
Median
$125.89
Typical High
$316.23
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$223.87
Median
$234.42
Typical High
$363.08
Aetna
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$52.48
Typical High
$134.90
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$33.11
Median
$67.61
Typical High
$134.90
Avera
Setting
Facility
Modifier
Global
Typical Low
$30.20
Median
$48.98
Typical High
$57.54
Avera
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$58.88
Typical High
$93.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$66.07
Typical High
$125.89
Medica
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$48.98
Typical High
$87.10
Medica
Setting
Facility
Modifier
62 · Two surgeons
Typical Low
$93.33
Median
$93.33
Typical High
$100.00
Medica
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$15.14
Median
$15.14
Typical High
$15.85
Medica
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$74.13
Typical High
$354.81
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$61.66
Median
$81.28
Typical High
$147.91
Midlands
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$69.18
Typical High
$109.65
Midlands
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$56.23
Typical High
$97.72
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$67.61
Typical High
$109.65
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$69.18
United
Setting
Professional
Modifier
Global
Typical Low
$28.18
Median
$58.88
Typical High
$104.71
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$79.43
Typical High
$89.13
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$46.77
Typical High
$89.13

Where South Dakota sits

The same service costs 1.6 times more in Minnesota 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.

South Dakota· 8th of 51

$54.95

MN $63.10DC $38.90

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.