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South Dakota rates for HCPCS 99235

Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, 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, 70 minutes must be met or exceeded.

Facilitymedian $126 · 10th–90th $110–$2450%20%10th90th$126Professionalmedian $275 · 10th–90th $204–$3240%20%10th90th$275$100.0$200.0

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
$109.65 / $123.03 / $144.54
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $234.42 / $323.59
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $323.59 / $323.59
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $275.42 / $323.59