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Preventive Visit, Established Patient, Age 65+

South Dakota rates for HCPCS 99397

This is a routine preventive checkup for an established patient age 65 or older, focused on prevention rather than a specific complaint. It typically includes a physical exam, review of medications and chronic conditions, and screening recommendations appropriate for the patient's age.

Rates data updated July 2026.

How much does Preventive Visit, Established Patient, Age 65+ cost?

$191

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $191 for this service. The price depends on where it is billed: about $191 from a physician practice, and about $135 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$191$123 to $269
FacilityA hospital or hospital-owned outpatient department$135$100 to $182

How much rates vary

Facilitymedian $135 · 10th to 90th $85 to $234Professionalmedian $191 · 10th to 90th $91 to $339
$50$100$200$500facility $135professional $191

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
$102.33
Median
$102.33
Typical High
$138.04
Aetna
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$190.55
Typical High
$338.84
Avera
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$100.00
Typical High
$154.88
Avera
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$181.97
Typical High
$218.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$190.55
Typical High
$295.12
Medica
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$134.90
Typical High
$234.42
Medica
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$229.09
Typical High
$851.14
Midlands
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$199.53
Typical High
$269.15
Midlands
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$177.83
Typical High
$302.00
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$177.83
Typical High
$263.03
United
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$181.97
United
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$165.96
Typical High
$281.84
Wellmark
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$28.84
Typical High
$28.84
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$147.91
Typical High
$239.88

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· 3rd of 51

$191

MN $224DE $107

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.