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ED visit level 5

CPT 99285 · negotiated-rate distribution across hospitals in SD

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Hospitals
5
Min
$1,390.62
Median
$1,835.24
Max
$5,382
Range multiplier
3.9×

By payer (36 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
TRICARE472$529.76$718.42$1,304.592.5×
UnitedHealthcare539$161.77$1,854.16$5,38233.3×
Blue Cross Blue Shield432$195.45$717.54$5,38227.5×
govt employees health assn [3081090]424$1,248.72$1,854.16$1,854.161.5×
medica (commercial) 94265 [3081118]424$1,570.36$1,854.16$1,854.161.2×
Cigna424$1,816.32$1,873.08$1,873.081.0×
healthpartners [3081368]421$656$1,854.16$1,854.162.8×
risk admin svs [3081167]416$290.08$901.84$1,513.65.2×
Meritain Health416$1,816.32$1,873.08$1,873.081.0×
national telephone cooperative assn 52103 [3081149]416$1,248.72$1,854.16$1,854.161.5×
Aetna412$1,702.8$1,750.1$1,797.41.1×
Humana59$1,702.8$1,892$5,3823.2×
tlc advantage llc [3081189]59$1,778.48$1,778.48$1,849.921.0×
midlands choice 47080 [3081136]48$1,816.32$1,873.08$1,873.081.0×
allied benefit systems inc [3081320]48$1,816.32$1,873.08$1,873.081.0×
avera health plans 46045 [3081018]48$1,390.62$1,835.24$1,835.241.3×
coresource 38225 [3081146]48$1,229.8$1,702.8$1,702.81.4×
employee benefit management 12x44 [3081079]48$1,608.2$1,702.8$1,702.81.1×
fedmed inc [3081283]48$1,797.4$1,835.24$1,835.241.0×
health partners sx009 [3081102]48$1,173.04$1,854.16$1,854.161.6×
key benefit administrators [3081332]48$1,816.32$1,873.08$1,873.081.0×
pacificsource health plans [3081333]48$1,608.2$1,702.8$1,702.81.1×
preferred one 41147 [3081160]48$1,816.32$1,873.08$1,873.081.0×
rocky mountain admin llc 83028 [3081168]48$1,513.6$1,702.8$1,702.81.1×
sanford health plan 91184 [3081174]48$1,702.8$1,835.24$1,835.241.1×
surest [3081369]48$1,248.72$1,854.16$1,854.161.5×
Medicare47$190.68$529.76$5,38228.2×
Multiplan24$1,702.8$1,769.02$1,835.241.1×
group and pension administrators inc [3081098]24$1,702.8$1,769.02$1,835.241.1×
triwest healthcare alliance [3081322]33$529.76$529.76$700.041.3×
va black hills health care system 12115 [3081206]33$529.76$529.76$700.041.3×
va black hills health care system 12115 [3081207]33$529.76$529.76$700.041.3×
VA Health33$529.76$529.76$700.041.3×
Health Net33$529.76$529.76$700.041.3×
va ccn optum [3081339]33$529.76$529.76$700.041.3×
minnesota health care programs 12k16 [3081295]12$573.28$573.28$573.281.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
MONUMENT HEALTH SPEARFISH HOSPITALSPEARFISHSD5$1,968$1,968$1,849.92$5,382$5,382
MONUMENT HEALTH LEAD-DEADWOOD HOSPITDEADWOODSD33$1,892$1,892$161.77$1,835.24$1,892
MONUMENT HEALTH STURGIS REGIONALSTURGISSD33$1,892$1,892$190.68$1,835.24$1,892
MONUMENT HEALTH CUSTER HOSPITALCUSTERSD35$1,892$1,892$190.68$1,835.24$1,892
MONUMENT HEALTH RAPID CITY HOSPITALRAPID CITYSD28$1,892$1,892$290.08$1,390.62$1,816.32

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.