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South Dakota rates for HCPCS 99253

Inpatient or observation 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, 45 minutes must be met or exceeded.

Facilitymedian $98 · 10th–90th $81–$1700%20%10th90th$98Professionalmedian $148 · 10th–90th $87–$3160%5%10%10th90th$148$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
$81.28 / $91.20 / $107.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $147.91 / $380.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $239.88 / $275.42
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $158.49 / $213.80
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $165.96 / $707.95
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $173.78 / $190.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $190.55 / $239.88
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $144.54