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First Day Hospital Care Visit, Moderate Level

South Dakota rates for HCPCS 99222

A physician's first visit with a patient admitted to the hospital or placed under observation. It includes taking the history and examining the patient, with moderately complex decision-making. Selection reflects about 55 minutes or more of care that day.

Rates data updated July 2026.

How much does First Day Hospital Care Visit, Moderate Level cost?

$123

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $123 for this service. The price depends on where it is billed: about $123 from a physician practice, and about $162 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$123$107 to $229
FacilityA hospital or hospital-owned outpatient department$162$123 to $191

How much rates vary

Facilitymedian $162 · 10th to 90th $102 to $245Professionalmedian $123 · 10th to 90th $102 to $302
$100$200facility $162professional $123

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$114.82
Typical High
$134.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$123.03
Typical High
$302.00
Avera
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$123.03
Avera
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$177.83
Typical High
$208.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$245.47
Typical High
$288.40
Medica
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$169.82
Typical High
$263.03
Medica
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$245.47
Typical High
$831.76
Midlands
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$257.04
Typical High
$257.04
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$218.78
Typical High
$251.19
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$229.09
Typical High
$295.12
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$218.78

Where South Dakota sits

The same service costs 2.1 times more in Wyoming 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· 47th of 51

$123

WY $219DC $105

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.