go back

South Dakota rates for HCPCS 99214

Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.

Facilitymedian $195 · 10th–90th $54–$5010%5%10%10th90th$195Professionalmedian $120 · 10th–90th $62–$2750%5%10%10th90th$120$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
$53.70 / $134.90 / $436.52
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$112.20 / $263.03 / $724.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $114.82 / $275.42
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$61.66 / $123.03 / $275.42
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $134.90 / $158.49
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $144.54 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $173.78 / $288.40
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $117.49 / $208.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $199.53 / $602.56
Medica
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$144.54 / $204.17 / $316.23
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $190.55 / $251.19
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $165.96 / $239.88
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $162.18 / $251.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $128.82 / $223.87
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $158.49 / $204.17
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $151.36 / $199.53