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Advance Care Planning Discussion

South Dakota rates for HCPCS 99497

A face-to-face conversation between a clinician and a patient, a family member or a person appointed to decide on their behalf, about the patient's wishes for future medical care. It covers explaining and discussing advance directives such as a living will or naming a healthcare proxy, and completing those forms if the patient wishes. It covers the first substantial block of time spent on the discussion.

Rates data updated July 2026.

Facilitymedian $98 · 10th–90th $62$1550%10%10th90th$98Professionalmedian $76 · 10th–90th $62$2040%10%20%10th90th$76$50.0$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
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$85.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$72.44
Typical High
$208.93
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$60.26
Median
$77.62
Typical High
$93.33
Avera
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$75.86
Typical High
$117.49
Avera
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$117.49
Typical High
$134.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$138.04
Typical High
$186.21
Medica
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$97.72
Typical High
$158.49
Medica
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$128.82
Typical High
$524.81
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$154.88
Median
$154.88
Typical High
$154.88
Midlands
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$151.36
Typical High
$165.96
Midlands
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$128.82
Typical High
$181.97
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$123.03
Typical High
$165.96
United
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$123.03
United
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$117.49
Typical High
$190.55
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$93.33
Typical High
$123.03