Outpatient office visit, established patient at Avera Behavioral Health Hospital

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Est Patient Level 3

Sioux Falls, SD

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Pricing by billing methodology

Price type

How this price compares nationally

Avera Behavioral Health Hospital’s median price of $121 is 2% below the median hospital's median price ($124), higher than 49% of the 2,009 hospitals reporting CPT 99213. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 99213 at Avera Behavioral Health Hospital

Negotiated rates from the hospital’s own file: 4 payers, 13 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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#
1	Wellmark hmo inpatient	$17.39	$17.39	$17.39 – $17.39
2	Wellmark ppo inpatient	$17.39	$17.39	$17.39 – $17.39
3	UnitedHealthcare com case rate · inpatient	$61.72	$61.72	$61.72 – $61.72
4	UnitedHealthcare com fee schedule · both	$98.49	$98.49	$98.49 – $98.49
5	Wellmark hmo fee schedule · both	$102.60	$102.60	$102.60 – $102.60
6	Wellmark ppo fee schedule · both	$102.60	$102.60	$102.60 – $102.60
7	Healthpartners com fee schedule · both	$115.60	$115.60	$115.60 – $115.60
8	Medica com fee schedule · both	$139.78	$139.78	$139.78 – $139.78
9	Medica ind fee schedule · both	$139.78	$139.78	$139.78 – $139.78
10	Healthpartners com percent of total billed charges · outpatientfrom % of charges	$215.75	$176.68	$59.47 – $215.75
11	Medica ind percent of total billed charges · outpatientfrom % of charges	$237.74	$194.69	$65.53 – $237.74
12	Medica com percent of total billed charges · outpatientfrom % of charges	$277.06	$226.89	$76.37 – $277.06
13	UnitedHealthcare com fee schedule · outpatient	$333.75	$333.75	$333.75 – $333.75

Last updated: Apr 1, 2026

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