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South Dakota rates for HCPCS 99221

Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.

Facilitymedian $74 · 10th–90th $56–$1170%20%10th90th$74Professionalmedian $112 · 10th–90th $63–$2140%10%10th90th$112$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
$56.23 / $63.10 / $74.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $107.15 / $218.78
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $125.89 / $131.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $165.96 / $181.97
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $109.65 / $173.78
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $154.88 / $616.60
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $190.55 / $190.55
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $154.88 / $173.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $147.91 / $199.53
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $138.04