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South Dakota rates for HCPCS 99213

Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.

Facilitymedian $195 · 10th–90th $51–$5370%5%10th90th$195Professionalmedian $85 · 10th–90th $52–$1950%10%10th90th$85$5.0$10.0$20.0$50.0$100.0$200.0$500.0

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
$51.29 / $165.96 / $537.03
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$165.96 / $245.47 / $630.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $85.11 / $199.53
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$46.77 / $85.11 / $186.21
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $91.20 / $107.15
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $107.15 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $117.49 / $204.17
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $81.28 / $147.91
Medica
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$151.36 / $151.36 / $186.21
Medica
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$23.99 / $23.99 / $29.51
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $138.04 / $416.87
Medica
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$100.00 / $134.90 / $199.53
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $128.82 / $177.83
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $112.20 / $162.18
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $112.20 / $177.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $87.10 / $158.49
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$48.98 / $95.50 / $144.54
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $102.33 / $144.54