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South Dakota rates for HCPCS 99243

Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.

Facilitymedian $107 · 10th–90th $79–$2000%10%20%10th90th$107Professionalmedian $107 · 10th–90th $72–$1620%10%10th90th$107$5.0$10.0$20.0$50.0$100.0$200.0$500.0

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
$72.44 / $95.50 / $125.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $104.71 / $144.54
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $104.71 / $208.93
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $134.90 / $234.42
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $194.98 / $741.31
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $223.87
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $158.49 / $218.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $141.25 / $239.88
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $128.82 / $165.96