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Annual Checkup, New Patient (Ages 40-64)

South Dakota rates for HCPCS 99386

A comprehensive first-time wellness visit for an adult patient between about 40 and 64 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 that become more relevant with age, such as certain screenings and lifestyle guidance. 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 40-64) cost?

$219

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $219 for this service. The price depends on where it is billed: about $219 from a physician practice, and about $155 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$219$138 to $324
FacilityA hospital or hospital-owned outpatient department$155$115 to $214

How much rates vary

Facilitymedian $155 · 10th to 90th $98 to $263Professionalmedian $219 · 10th to 90th $115 to $355
$50.0$100.0$200.0$500.0$1.0Kfacility $155professional $219

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
$120.23
Median
$120.23
Typical High
$154.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$223.87
Typical High
$363.08
Avera
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$208.93
Typical High
$245.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$218.78
Typical High
$331.13
Medica
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$158.49
Typical High
$269.15
Medica
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$239.88
Typical High
$954.99
Midlands
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$234.42
Typical High
$302.00
Midlands
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$199.53
Typical High
$338.84
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$199.53
Typical High
$288.40
United
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$204.17
Typical High
$204.17
United
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$190.55
Typical High
$309.03
Wellmark
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$28.84
Typical High
$28.84
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$173.78
Typical High
$269.15

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. Pick one to see its carriers and full range.

South Dakota $219 · 4th of 51
MN $257DE $120

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.