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Hospital Consultation, Lower Complexity

South Dakota rates for HCPCS 99252

A specialist's opinion on a hospital patient, requested by the doctor already caring for them. The consultant takes a history, examines the patient, reviews the records, and writes back with advice. This is one of the shorter consultations of its kind, for a problem that is fairly limited in complexity.

Rates data updated July 2026.

How much does Hospital Consultation, Lower Complexity cost?

$158

Typical physician fee. In South Dakota, July 2026.

Insurers have agreed to pay about $158 for this service. Most negotiated rates run $126 to $186.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $112 · 10th to 90th $63 to $151Professionalmedian $158 · 10th to 90th $66 to $195
$100$200facility $112professional $158

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$63.10
Typical High
$74.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$162.18
Typical High
$194.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$158.49
Typical High
$181.97
Medica
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$123.03
Typical High
$169.82
Medica
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$107.15
Typical High
$524.81
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$120.23
Typical High
$134.90
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$125.89
Typical High
$162.18
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$95.50
Typical High
$100.00

Where South Dakota sits

The same service costs 2.3 times more in South Dakota than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Dakota· 1st of 51

$158

SD $158DC $67.61

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.