go back

South Dakota rates for HCPCS G2004

Comprehensive (60 minutes) in-home visit for a new patient postdischarge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than nine times.)

Facilitymedian $148 · 10th–90th $129–$2040%50%10th90th$148Professionalmedian $155 · 10th–90th $120–$2690%20%10th90th$155$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $144.54 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $177.83 / $218.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $147.91 / $316.23
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $302.00 / $1,096.48
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $302.00 / $302.00
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $218.78 / $309.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $316.23 / $436.52
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $229.09 / $229.09