go back

South Dakota rates for HCPCS 99242

Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $61.66 / $83.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $72.44 / $138.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $74.13 / $144.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $89.13 / $169.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $141.25 / $537.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $112.20 / $147.91
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $107.15 / $151.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $102.33 / $154.88
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $81.28 / $109.65