Average Medicaid Office Visit Payments in Sioux Falls, SD: $50.32
Avg. Paid
$50.32
Range
$0.00 – $687.82
Total Claims
948,639
Providers
260
Typical Payment Range
Typical Medicaid Office Visit payments fall between $29.28 and $67.92 per claim (median: $46.55). The top 10% of payments exceed $95.29.
Based on per-provider averages across all Medicaid claims in this category.
A standard doctor's office visit for evaluation and management of medical conditions. Includes new patient visits, follow-up visits, and consultations.
Understanding these costs
The amounts shown are Medicaid reimbursement rates — what state Medicaid programs paid providers per claim. Medicaid typically pays well below private insurance rates and out-of-pocket prices. Use this data to compare relative costs between providers, not as a price estimate for privately insured or self-pay patients.
Providers Offering Office Visit in Sioux Falls, SD
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Sanford Medical Center
1420 W 22Ndst Ste 104 |
$47.48 | 482,117 | 392,342 |
|
Avera Mckennan
1200 S 7Th Ave |
$44.52 | 122,613 | 104,229 |
|
City Of Sioux Falls
521 N Main Ave |
$109.29 | 26,258 | 21,050 |
|
Sanford Clinic
1600 W 22Nd St |
$57.48 | 23,237 | 19,450 |
|
Avera Mckennan
4400 W 69Th St Ste 1500 |
$57.83 | 22,209 | 20,252 |
|
Center For Family Medicine
1115 E 20Th St |
$50.15 | 20,848 | 17,944 |
|
Avera Mckennan
6100 S Louise Ave Ste 2100 |
$47.79 | 14,374 | 12,109 |
|
Avera Mckennan
1417 S. Cliff Ave. |
$67.04 | 12,567 | 10,664 |
|
Midwest Ear, Nose & Throat Associates P C
2315 W 57Th St |
$49.52 | 8,912 | 7,289 |
|
Avera Mckennan
1301 S. Cliff Ave. |
$46.74 | 8,845 | 7,679 |
|
David A Welch
1001 E. 21St St. |
$26.76 | 8,744 | 7,853 |
|
Kristi Ross
326 E 8Th St Apt 206 |
$71.12 | 7,948 | 4,552 |
|
Avera Mckennan
1000 E. 23Rd St. |
$42.68 | 7,171 | 5,440 |
|
Lauren Hsiao
4405 E 26Th St |
$0.05 | 6,796 | 3,789 |
|
Sanford Clinic
2400 W 49Th St |
$35.86 | 6,462 | 6,031 |
|
Santiago Enrique Encalada
1600 W 22Nd St |
$125.51 | 5,596 | 5,551 |
|
Avera Mckennan
6100 S Louise Ave Ste 1120 |
$37.10 | 5,483 | 4,638 |
|
Avera Mckennan
6701 S Minnesota Ave |
$44.50 | 5,340 | 4,622 |
|
Heart Hospital Of South Dakota Llc
4520 W 69Th St |
$43.75 | 5,219 | 4,631 |
|
Volunteers Of America, Dakotas
1309 W. 51St Street |
$21.61 | 4,966 | 2,116 |
|
Urology Specialists Chartered
201 W 69Th St |
$38.14 | 4,793 | 4,356 |
|
Rosanne Linda Bosch
1205 S Grange Ave |
$50.04 | 4,182 | 3,971 |
|
Sanford Clinic
1500 W 22Nd St |
$48.95 | 4,014 | 3,248 |
|
Jennifer S. Clark
4000 N Brendan Ln |
$27.63 | 3,943 | 3,567 |
|
Sabrina Leigh Taylor
1200 S 7Th Ave |
$45.44 | 3,912 | 3,549 |
|
Southeastern Behavioral Healthcare
2000 S Summit Ave |
$32.75 | 3,654 | 3,345 |
|
Avera Mckennan
1600 S Highline Ave Ste 310 |
$42.06 | 3,445 | 3,026 |
|
Avera Mckennan
1417 S. Cliff Ave. |
$42.45 | 3,367 | 2,779 |
|
Hayley Frances Klein
1621 S Minnesota Ave |
$55.22 | 3,252 | 2,752 |
|
South Dakota Urban Indian Health, Inc. Sduih
1200 N West Ave |
$114.88 | 3,086 | 2,578 |
|
Sanford Clinic
1309 W 17Th St |
$42.17 | 2,535 | 2,088 |
|
Sanford Clinic
1305 W 18Th St |
$78.92 | 2,499 | 2,240 |
|
Ophthalmology Ltd
6601 S Minnesota Ave |
$39.23 | 2,473 | 2,206 |
|
Eduardo Bonilla Trejos
1321 W 22Nd St |
$92.62 | 2,436 | 2,410 |
|
Maria Louisa Stunkel
1400 W 22Nd St |
$98.94 | 2,394 | 2,336 |
|
Rashmi Jain
1600 W 22Nd St |
$75.99 | 2,373 | 2,333 |
|
Avera Mckennan
1301 S Cliff Ave Ste 4400 |
$31.48 | 2,210 | 1,988 |
|
Avera Mckennan
6100 S Louise Ave Ste 3100 |
$38.23 | 2,208 | 2,026 |
|
Avera Mckennan
4400 W 69Th St |
$47.46 | 2,072 | 1,927 |
|
Avera Mckennan
6100 S Louise Ave Ste 1130 |
$44.98 | 2,067 | 1,810 |
|
Jamie Kay Grant
1305 W 18Th St |
$38.31 | 2,016 | 1,974 |
|
Avera Mckennan
1417 S. Cliff Ave. |
$36.59 | 1,861 | 1,265 |
|
Avera Mckennan
6709 S Minnesota Ave Ste 102 |
$46.57 | 1,816 | 1,536 |
|
Christopher G Hanley
4400 W 69Th St |
$109.00 | 1,771 | 1,632 |
|
Udit Bhaskar Bhatnagar
1301 W 18Th St |
$73.53 | 1,757 | 1,688 |
|
Sanford Clinic
1301 W 18Th St |
$40.56 | 1,691 | 1,553 |
|
Angela R. Gulbranson Od, Pc
6205 S Minnesota Ave |
$15.91 | 1,688 | 607 |
|
Lianne Farley
1600 S Highline Ave |
$40.75 | 1,681 | 1,618 |
|
Dakota Allergy & Asthma Ltd
2200 W 49Th St Ste 104 |
$47.06 | 1,618 | 1,477 |
|
Silver Lining Integrative Psychiatry
510 S Valley View Rd Ste 2 |
$55.23 | 1,598 | 1,007 |
What to Expect: Office Visit
A typical office visit lasts 15-45 minutes depending on complexity. Your doctor will review your medical history, discuss symptoms, perform a physical exam, and discuss treatment options. You may receive prescriptions, referrals, or orders for diagnostic tests. Follow-up visits are usually shorter than new patient visits.
Cost Components
National average Medicaid payment per billing code. Individual rates vary by provider and state.
| Code | Description | Avg. Paid | Claims | Providers |
|---|---|---|---|---|
| 99213 | Office visit established mod | $43.18 | 764,306,590 | 487,602 |
| 99214 | Office visit established mod-hi | $59.53 | 502,480,931 | 466,856 |
| 99212 | Office visit established low | $41.69 | 92,299,154 | 127,462 |
| 99203 | Office visit new moderate | $67.55 | 47,756,882 | 127,334 |
| 99211 | Office visit established minor | $39.24 | 44,127,221 | 47,748 |
| 99204 | Office visit new moderate-high | $92.03 | 32,379,031 | 111,937 |
| 99215 | Office visit established high | $93.58 | 29,619,773 | 74,725 |
| 99202 | Office visit new low | $58.57 | 9,372,712 | 35,486 |
| 99205 | Office visit new high | $136.10 | 3,665,382 | 19,737 |
| 99244 | Office consultation mod-high | $118.25 | 3,405,681 | 11,884 |
| 99243 | Office consultation moderate | $78.55 | 2,585,480 | 8,432 |
| 99245 | Office consultation high | $132.29 | 645,300 | 3,046 |
| 99242 | Office consultation low | $58.27 | 483,445 | 1,980 |
| 99241 | Office consultation brief | $66.15 | 295,664 | 712 |
These are national Medicaid averages for each billing code. Actual amounts vary by state, provider, and complexity.
Frequently Asked Questions
How much does a Office Visit cost in Sioux Falls, SD?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Sioux Falls, SD is $50.32 per claim, based on 948,639 claims from 260 providers. Typical payments fall between $29.28 and $67.92. Note: Medicaid rates are typically much lower than private insurance or self-pay prices.
How many providers offer Office Visit in Sioux Falls, SD?
There are 260 Medicaid providers offering Office Visit related services in Sioux Falls, SD according to public payment data.
What is the price range for Office Visit in Sioux Falls, SD?
Medicaid reimbursement for Office Visit in Sioux Falls, SD ranges from $0.00 to $687.82 per claim, with an average of $50.32. Private insurance and self-pay costs are typically higher than these Medicaid rates.
Office Visit in Other Cities
Brooklyn, NY
Avg $71.20
32,336,840 claims · 5588 providers
New York, NY
Avg $81.86
23,551,154 claims · 7530 providers
Los Angeles, CA
Avg $24.20
16,948,065 claims · 5565 providers
Chicago, IL
Avg $30.31
13,989,780 claims · 5801 providers
Bronx, NY
Avg $82.40
13,626,712 claims · 3705 providers
Phoenix, AZ
Avg $47.53
13,269,420 claims · 4233 providers
Houston, TX
Avg $48.27
8,766,644 claims · 4540 providers
Las Vegas, NV
Avg $54.47
8,578,324 claims · 3512 providers
Other Procedures in Sioux Falls, SD
Blood Work & Lab Tests
Avg $10.61
501,187 claims
Vaccines & Immunizations
Avg $11.07
358,214 claims
Psychiatric Evaluation
Avg $63.31
349,102 claims
X-Ray
Avg $9.88
280,494 claims
Emergency Room Visit
Avg $92.67
213,799 claims
Personal Care Services
Avg $119.40
213,761 claims
Speech Therapy
Avg $21.62
173,302 claims
Home Health Visit
Avg $98.45
161,116 claims