Tynbil: Know the *real* price for healthcare services

South Dakota rates for HCPCS 99225

Subsequent observation care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is responding inadequately to therapy or has developed a minor complication. Typically, 25 minutes are spent at the bedside and on the patient's hospital floor or unit.

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.68 / $122.90 / $152.10	Professional	$121.68	$122.90	$152.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $335.79 / $335.79 / $335.79	Professional	$335.79	$335.79	$335.79
Midlands Facility/Professional Facility Modifier Low / Median / High Price $109.74 / $109.74 / $109.74	Facility	$109.74	$109.74	$109.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $109.74 / $148.66	Professional	$70.79	$109.74	$148.66
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $87.96 / $118.94 / $165.69	Professional	$87.96	$118.94	$165.69