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South Dakota

Cost of a ER Visit (High) Visit
in South Dakota

Reviewed by Momentary Medical Group West PC

South Dakota's rural geography means emergency departments often serve as the primary access point for high-severity medical care across vast distances. Patients requiring a ER Visit (High) typically pay between $97 and $161, with a median out-of-pocket cost of $97 based on negotiated insurance rates. South Dakota maintains 350 active ER Visit (High) providers across the state, allowing patients to browse all available emergency care options throughout South Dakota's healthcare network.

Average

$119

Median

$98

Lowest

$98

Highest

$161

Providers

350

National avg: $189South Dakota: $119

37% below national average

Compare Similar Procedures

How does er visit (high severity) compare to related procedures in South Dakota?

ProcedureCPTLowMedianHighProviders
ER Visit (Low Severity)

Emergency department visit, low severity

99283$40$40$88345
ER Visit (Moderate Severity)

Emergency department visit, moderate severity

99284$62$62$121352

Important: These are cost estimates only — not a quote and not medical advice.

The prices on this page are self-pay rates, drawn from federal Transparency in Coverage machine-readable files (CPT 99285Emergency department visit, high severity). They represent what a patient might pay without insurance.

Your actual cost depends on: your specific insurance plan, your remaining deductible, your coinsurance percentage, whether you have met your out-of-pocket maximum, whether the facility and provider are both in-network, and any separate anesthesia or implant fees billed independently.

This page does not constitute medical advice. Whether you need this procedure, and which approach is right for you, is a decision to make with a licensed healthcare provider.

Where this data comes from & what CPT 99285 covers

Data source: Cost figures are derived from UnitedHealthcare Transparency in Coverage machine-readable files for CPT code 99285 (Emergency department visit, high severity), as mandated by the CMS Price Transparency Rule.

What CPT 99285 covers: the provider's professional fee for er visit (high severity). It does not include facility/hospital fees, anesthesia, pre-operative imaging, post-operative care, or any add-on codes billed separately.

How to read this data

Negotiated Rate

The discounted price an insurer has agreed to pay a specific provider. Most insured patients' bills are calculated from this number, not the higher list price hospitals publish separately.

P5, Median, P95

P5 is the rate at the 5th percentile (low end), Median is the middle value, and P95 is the 95th percentile (high end). This range shows how much the same visit can vary between providers.

What this does not tell you

These rates do not tell you what you personally will pay out of pocket. That depends on your specific plan, how much of your deductible you have already met, your coinsurance rate, and whether the provider is in your network. Call your insurer's member line to get your exact estimate.

Top-Rated Hospitals in South Dakota

These hospitals in South Dakota are top-rated for patient satisfaction. Review data sourced from HCAHPS Patient Survey.

5/5
93% would recommend805 patient surveys
5/5
91% would recommend609 patient surveys
5/5
86% would recommend298 patient surveys
DUNES SURGICAL HOSPITAL

DAKOTA DUNES, SD

5/5
85% would recommend192 patient surveys
5/5
85% would recommend218 patient surveys

Hospital ratings are based on HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey data published by CMS.

Why ER Visit (High) Visit Costs Vary Across South Dakota

South Dakota's healthcare costs run approximately 3% above the national average, influenced by the state's rural geography and limited provider competition in many regions. The state's scattered population and vast distances between medical facilities create unique cost pressures for emergency services.

Urban vs. Rural Provider Availability

Sioux Falls and Rapid City anchor South Dakota's emergency care network, with comprehensive medical centers serving large geographic regions. Rural areas rely heavily on critical access hospitals that may lack specialized emergency capabilities, often requiring expensive transfers to regional centers. The distance between facilities can drive up costs through ambulance transport and delay definitive care.

Facility Type and Overhead Costs

Sanford Health and Monument Health dominate South Dakota's hospital landscape, operating both major medical centers and rural facilities with varying cost structures. Critical access hospitals in rural areas face higher per-patient overhead costs due to lower volumes but federal reimbursement protections. Major health systems can leverage economies of scale but may charge premium rates for specialized emergency services.

Insurance Market Competition in South Dakota

Limited insurer competition between Wellmark Blue Cross Blue Shield, Sanford Health Plan, and UnitedHealthcare reduces negotiating pressure on emergency care rates. Rural markets may have even fewer insurance options, giving dominant insurers significant leverage in rate negotiations. The lack of robust competition can result in higher negotiated rates that ultimately affect patient cost-sharing.

Physician Supply and Demand in South Dakota

South Dakota's 350 active emergency medicine providers serve a geographically dispersed population, creating coverage challenges in remote areas. Rural physician shortages mean some emergency departments rely on locum physicians or telemedicine consultations, potentially affecting costs. The maldistribution of providers between urban centers and rural areas can drive up wages and facility costs in underserved regions.

JP

Jayant Panwar

CEO, Momentary Labs · San Francisco, CA

Jayant has analyzed healthcare pricing data from CMS Transparency in Coverage files since 2022, covering more than 50 million negotiated rate records across all 50 states. His work focuses on making insurer machine-readable files accessible to patients and researchers.

The cost figures on this page reflect his ongoing work to make this data accessible to patients.

Healthcare Data AnalyticsCMS TiC DataInsurance Price Transparency

Frequently Asked Questions — ER Visit (High) Costs in South Dakota

What is the average cost of a ER Visit (High) visit in South Dakota without insurance?

Without insurance, high-severity emergency visits in South Dakota typically cost between $97 and $161 based on negotiated rates, though uninsured patients often face higher list prices. The median cost is $97, but complex cases requiring extensive testing, procedures, or hospital admission can reach several thousand dollars. Many South Dakota hospitals offer self-pay discounts of 20-40% for uninsured patients who pay promptly or qualify for charity care programs.

Does South Dakota Medicaid cover ER Visit (High) visits?

South Dakota Medicaid covers emergency services for eligible recipients, including high-severity emergency department visits when medically necessary. However, South Dakota has not expanded Medicaid, leaving many low-income adults without coverage who may struggle to pay for emergency care. Traditional Medicaid recipients should expect minimal out-of-pocket costs for covered emergency services, though some copays may apply depending on income level.

How do I find an affordable ER Visit (High) near me in South Dakota?

Compare facility fees and physician charges across different emergency departments in your area, as costs can vary significantly between critical access hospitals and major medical centers. Ask about self-pay discounts, payment plans, and charity care programs if you're uninsured or underinsured. Consider urgent care centers for conditions that seem severe but may not require true emergency intervention, as these typically cost much less than emergency department visits.

What is the difference in cost between an initial consultation and a follow-up visit?

Emergency department visits are typically coded as single encounters rather than initial consultations versus follow-up visits like in outpatient settings. However, return visits to the emergency department within 72 hours for the same condition may be bundled or discounted depending on the hospital's policies. Follow-up care is usually transitioned to outpatient specialists or primary care providers rather than continued emergency department management.

Can I use an HSA or FSA to pay for a ER Visit (High) visit in South Dakota?

Yes, emergency department visits qualify as eligible medical expenses for both Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA). This includes all associated costs such as facility fees, physician charges, diagnostic tests, and medications provided during your emergency visit. Keep all receipts and documentation for tax purposes, as these accounts can provide significant tax savings on high-cost emergency care.

How does telemedicine affect the cost of seeing a ER Visit (High) in South Dakota?

Telemedicine can help triage urgent concerns and potentially avoid unnecessary emergency department visits for conditions that can be managed remotely. Some South Dakota hospitals offer virtual urgent care services at lower costs than emergency department visits for non-emergent concerns. However, true high-severity emergencies requiring immediate intervention, testing, or procedures cannot be handled through telemedicine and still require in-person emergency care.

Click a state to compare costs

Average Visit Cost

$114
$430

Office visit (CPT 99285)

Compare With Other States

RankStateAverage
1Wisconsin
Range: $73$940
$430
2New Hampshire
Range: $150$446
$294
3Illinois
Range: $80$569
$285
4Iowa
Range: $85$538
$275
5Louisiana
Range: $98$536
$261
6New York
Range: $80$543
$260
7Maine
Range: $170$337
$251
8Nebraska
Range: $123$422
$236
9Washington
Range: $80$379
$224
10Colorado
Range: $80$390
$219
11New Mexico
Range: $88$389
$218
12Wyoming
Range: $88$385
$217
13Vermont
Range: $98$356
$216
14Rhode Island
Range: $80$429
$202
15Massachusetts
Range: $80$428
$202
16Georgia
Range: $85$333
$198
17North Carolina
Range: $80$330
$188
18District of Columbia
Range: $85$305
$185
19Maryland
Range: $88$298
$183
20Michigan
Range: $80$318
$183
21Utah
Range: $80$317
$182
22New Jersey
Range: $60$348
$182
23Ohio
Range: $85$287
$181
24Mississippi
Range: $126$250
$181
25California
Range: $80$374
$181
26Hawaii
Range: $80$313
$179
27Arkansas
Range: $85$282
$178
28Virginia
Range: $88$293
$177
29Tennessee
Range: $85$259
$170
30South Carolina
Range: $80$287
$170
31Missouri
Range: $88$239
$168
32Minnesota
Range: $91$312
$167
33Oklahoma
Range: $85$246
$166
34Kansas
Range: $88$243
$166
35Alabama
Range: $80$257
$160
36Pennsylvania
Range: $55$334
$159
37Arizona
Range: $80$250
$157
38Indiana
Range: $85$298
$157
39West Virginia
Range: $88$281
$155
40Delaware
Range: $85$203
$155
41Kentucky
Range: $80$296
$155
42Nevada
Range: $85$267
$154
43Alaska
Range: $80$292
$151
44Connecticut
Range: $55$320
$148
45Idaho
Range: $80$275
$148
46Oregon
Range: $80$250
$142
47Texas
Range: $80$257
$142
48Montana
Range: $80$213
$124
49North Dakota
Range: $91$177
$122
50South Dakota
Range: $98$161
$119
51Florida
Range: $35$246
$114
ER Visit (High Severity) in Other States