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South Dakota rates for HCPCS 99245

Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.

Facilitymedian $200 · 10th–90th $151–$3800%10%20%10th90th$200Professionalmedian $195 · 10th–90th $145–$2950%10%20%10th90th$195$10.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $190.55 / $229.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $194.98 / $263.03
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $346.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $199.53 / $398.11
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $257.04 / $407.38
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $354.81 / $1,348.96
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $416.87
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $295.12 / $407.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $263.03 / $416.87
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $263.03 / $309.03