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South Dakota rates for HCPCS 99223

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 high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.

Facilitymedian $158 · 10th–90th $117–$6920%10%20%10th90th$158Professionalmedian $214 · 10th–90th $141–$4570%10%20%10th90th$214$100.0$200.0$500.0$1.0K

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
$117.49 / $158.49 / $691.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $199.53 / $457.09
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $165.96 / $165.96
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $239.88 / $281.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $354.81 / $389.05
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $229.09 / $371.54
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $338.84 / $1,202.26
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $389.05 / $389.05
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $316.23 / $354.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $295.12 / $398.11
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $295.12