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South Dakota rates for HCPCS 99222

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 moderate level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.

Facilitymedian $115 · 10th–90th $87–$1950%20%10th90th$115Professionalmedian $132 · 10th–90th $102–$3090%10%20%10th90th$132$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
$87.10 / $100.00 / $117.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $128.82 / $309.03
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $131.83 / $204.17
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $173.78 / $208.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $257.04 / $288.40
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $169.82 / $263.03
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $245.47 / $831.76
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $257.04 / $257.04
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $223.87 / $263.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $218.78 / $295.12
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $218.78