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Comprehensive Specialist Consultation Visit

South Dakota rates for HCPCS 99245

This is an in-depth office visit where a specialist evaluates a patient at the request of another provider, involving a thorough review of the patient's history, a detailed examination, and complex medical decision-making. It represents the most involved level of this type of consultation, typically used for patients with complicated or multiple medical problems. A written report is usually sent back to the referring provider afterward.

Rates data updated July 2026.

Facilitymedian $251 · 10th–90th $170$4070%10%10th90th$251Professionalmedian $195 · 10th–90th $148$3390%10%10th90th$195$20.0$50.0$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
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$190.55
Typical High
$223.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$181.97
Typical High
$234.42
Avera
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$346.74
Typical High
$346.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$199.53
Typical High
$398.11
Medica
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$257.04
Typical High
$407.38
Medica
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$354.81
Typical High
$1,348.96
Midlands
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$363.08
Typical High
$416.87
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$295.12
Typical High
$407.38
United
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$269.15
Typical High
$416.87
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$251.19
Typical High
$295.12