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Annual Checkup, New Patient (Ages 18-39)

South Dakota rates for HCPCS 99385

A comprehensive first-time wellness visit for an adult patient between about 18 and 39 who is new to this provider, focused on preventive care rather than an existing illness. It typically includes a full health history, an age-appropriate physical exam, and counseling on preventive topics such as screenings, immunizations, and healthy lifestyle habits. It's meant to establish a baseline and catch potential health issues early.

Rates data updated July 2026.

How much does Annual Checkup, New Patient (Ages 18-39) cost?

$162

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $162 for this service. The price depends on where it is billed: about $162 from a physician practice, and about $132 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$162$115 to $263
FacilityA hospital or hospital-owned outpatient department$132$97.72 to $182

How much rates vary

Facilitymedian $132 · 10th to 90th $81 to $224Professionalmedian $162 · 10th to 90th $95 to $309
$50$100$200facility $132professional $162

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$131.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$162.18
Typical High
$309.03
Avera
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
Avera
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$181.97
Typical High
$213.80
Cigna
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$181.97
Typical High
$288.40
Medica
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$131.83
Typical High
$229.09
Medica
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$208.93
Typical High
$812.83
Midlands
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$190.55
Typical High
$263.03
Midlands
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$173.78
Typical High
$295.12
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$173.78
Typical High
$251.19
United
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
United
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$158.49
Typical High
$269.15
Wellmark
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$28.84
Typical High
$28.84
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$141.25
Typical High
$234.42

Where South Dakota sits

The same service costs 2.1 times more in Minnesota than in Delaware. 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· 8th of 51

$162

MN $214DE $102

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.