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FQHC Visit, Established Patient

South Dakota rates for HCPCS G0467

Federally Qualified Health Center (FQHC) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a FQHC practitioner during which time one or more FQHC services are rendered and includes a typical bundle of Medicare-covered services that would be furnished per diem to a patient receiving a FQHC visit

Rates data updated July 2026.

How much does FQHC Visit, Established Patient cost?

$162

Typical physician fee. In South Dakota, July 2026.

Insurers have agreed to pay about $162 for this service. Most negotiated rates run $95.50 to $204.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $117 · 10th to 90th $85 to $191Professionalmedian $162 · 10th to 90th $95 to $204
$100.0$200.0facility $117professional $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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$162.18
Typical High
$204.17
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Medica
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$117.49
Typical High
$199.53
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$74.13
Typical High
$74.13

Where South Dakota sits

The same service costs 2.2 times more in Minnesota than in New Hampshire. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

South Dakota $162 · 3rd of 51
MN $182NH $83.18

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.